Individual
HEATHER GARDINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 706-5811
(541) 706-5867
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD192173
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2016
Last updated
09/14/2020
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