Individual
HEATHER GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 NE HALSEY ST BLDG 2, PORTLAND, OR 97213-1545
(503) 893-6472
(503) 215-6240
Mailing address
9660 SW SADDLE DR, BEAVERTON, OR 97008-6744
(503) 524-2061
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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