Individual
HEIDI KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5847 NE 122ND AVE, PORTLAND, OR 97230-1079
(971) 276-3571
Mailing address
8523 SE 9TH AVE, PORTLAND, OR 97202-6914
(971) 276-3571
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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