Individual
MRS. HOLLY LYNN HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4310 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1404
(503) 535-1181
Mailing address
9200 SW 156TH PL, BEAVERTON, OR 97007-6370
(503) 997-9465
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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