Provider Demographics
NPI:1992959720
Name:BARTLETT, HEATHER KELLY MARIE (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:KELLY MARIE
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13030 MILITARY RD S
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3085
Mailing Address - Country:US
Mailing Address - Phone:206-246-2886
Mailing Address - Fax:206-246-5457
Practice Address - Street 1:13030 MILITARY RD S
Practice Address - Street 2:SUITE 106
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-3085
Practice Address - Country:US
Practice Address - Phone:206-246-2886
Practice Address - Fax:206-246-5457
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH51015650208600000X
WAMD60248964207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery