Provider Demographics
NPI:1982809745
Name:HEESTAND, JEAN ESTHER (PHD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:ESTHER
Last Name:HEESTAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21611 9TH PL W
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-8165
Mailing Address - Country:US
Mailing Address - Phone:425-481-2076
Mailing Address - Fax:
Practice Address - Street 1:21611 9TH PL W
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-8165
Practice Address - Country:US
Practice Address - Phone:206-619-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health