Basic Information
| Provider Information | |||||||||
| NPI: | 1700042371 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEUGEL | ||||||||
| FirstName: | JUDSON | ||||||||
| MiddleName: | RYAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16233 SYLVESTER RD SW STE 230 | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981663044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062427822 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16233 SYLVESTER RD SW STE 230 | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981663044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062427822 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2008 | ||||||||
| LastUpdateDate: | 05/22/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | D0071995 | MD | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | MD60511475 | WA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.