Provider Demographics
NPI:1194709469
Name:KRESKEN, HEIDI L (ARNP)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:L
Last Name:KRESKEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:LYNNE
Other - Last Name:PFEIFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:UNIVERSITY OF WASHINGTON MEDICAL CENTER
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6171
Mailing Address - Country:US
Mailing Address - Phone:206-598-2966
Mailing Address - Fax:206-598-4824
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:UNIVERSITY OF WASHINGTON MEDICAL CENTER
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6171
Practice Address - Country:US
Practice Address - Phone:206-598-2966
Practice Address - Fax:206-598-4824
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006626363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9639592Medicaid
WA9639592Medicaid
Q05413Medicare UPIN