Provider Demographics
NPI:1386625176
Name:HEISE, SHERRI A (PHARMD, CACP)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:A
Last Name:HEISE
Suffix:
Gender:F
Credentials:PHARMD, CACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9011 RIDGEVIEW CIR W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-1334
Mailing Address - Country:US
Mailing Address - Phone:253-565-5139
Mailing Address - Fax:
Practice Address - Street 1:4545 POINT FOSDICK DR NW
Practice Address - Street 2:SUITE #250
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1700
Practice Address - Country:US
Practice Address - Phone:253-530-8090
Practice Address - Fax:253-530-8081
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00012023183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist