Provider Demographics
NPI:1043476898
Name:HECKLER, ADRIENNE MICHELLE (MD)
Entity type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:MICHELLE
Last Name:HECKLER
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 1:700 NE 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664
Mailing Address - Country:US
Mailing Address - Phone:360-882-2778
Mailing Address - Fax:360-604-1771
Practice Address - Street 1:2525 NE 139TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686
Practice Address - Country:US
Practice Address - Phone:360-882-2778
Practice Address - Fax:360-604-1787
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR208800000X208800000X
WAMD60368349208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology