Provider Demographics
NPI:1427104405
Name:TAFJORD, HEIDI R (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:R
Last Name:TAFJORD
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 NW 70TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-6134
Mailing Address - Country:US
Mailing Address - Phone:206-495-5393
Mailing Address - Fax:206-535-6876
Practice Address - Street 1:3409 NW 70TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-6134
Practice Address - Country:US
Practice Address - Phone:206-495-5393
Practice Address - Fax:206-535-6876
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60510333363LP0808X
OR200550002NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health