# GOLDMARK WOUND SPECIALTY GROUP DESCHUTES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356166482
- **Authorized official:** DR. HEIDI HAGMAN MD (OWNER/ MEDICAL DIRECTOR)
- **Authorized official phone:** (971) 910-3888

## Contact information

- **Practice address:** 7150 SW HAMPTON ST STE 101, TIGARD, OR 97223-8365
- **Practice address phone:** (971) 236-4445
- **Practice address fax:** (971) 236-4445
- **Mailing address:** 7150 SW HAMPTON ST STE 101, TIGARD, OR 97223-8365
- **Mailing address phone:** (971) 236-4445
- **Mailing address fax:** (971) 236-4445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/22/2024
- **Last updated:** 11/22/2024