Provider Demographics
NPI:1902235484
Name:IWASHITA, HEIDI (MS)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:
Last Name:IWASHITA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MELISSA
Other - Last Name:HOEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1007
Mailing Address - Country:US
Mailing Address - Phone:360-532-5122
Mailing Address - Fax:360-532-9048
Practice Address - Street 1:920 ANDERSON DR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1007
Practice Address - Country:US
Practice Address - Phone:360-532-5122
Practice Address - Fax:360-532-9048
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60385384235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist