Individual provider Active NPI

Heather Liedl, PA-C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1710364526
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60794247 Issued in WA
Practice address
310 15TH Ave E
Seattle, WA 98112-5103
Phone
(206) 326-3000
Fax
(877) 515-2975
NPI assigned
Apr 30, 2015
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60794247 WA Primary

Addresses

Primary practice location

310 15TH Ave E
Seattle, WA 98112-5103

Mailing address

700 Broadway E Unit 117
Seattle, WA 98102-7600
Phone (612) 209-6116

Other practice location 1

298 S Yonge St
Ormond Beach, FL 32174-6264
Phone (386) 274-7840

Other practice location 2

1901 S Union Ave
Tacoma, WA 98405-1702
Phone (253) 459-6352

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171205001526 WA Practitioner - Physician Assistant 8921319880 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 15TH Ave E
Seattle, WA 98112-5260
Phone (206) 326-3000

201 16TH Ave E
Seattle, WA 98112-5226
Phone (206) 326-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tacoma Emergency Care Physicians, PLLC CurrentSince Oct 31, 2017 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2023 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2023 Accepting new patients

Locations

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

310 15th Ave E
Seattle, WA 98112
Phone (206) 326-3500

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: hliedl4287094@ghc.direct-ci.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1710364526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 BROADWAY E UNIT 117",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981027600",
            "telephone_number": "612-209-6116",
            "fax_number": "626-623-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 15TH AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125103",
            "telephone_number": "206-326-3000",
            "fax_number": "877-515-2975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "298 S Yonge St",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321746264",
            "country_code": "US",
            "telephone_number": "386-274-7840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 S Union Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984051702",
            "country_code": "US",
            "telephone_number": "253-459-6352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEDL",
        "first_name": "HEATHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60794247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "310 15th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.