Individual
MISS HEIDI LYNN TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9250 SW HALL BLVD, TIGARD, OR 97223-6721
(503) 293-0161
Mailing address
800 SW 13TH AVE, PORTLAND, OR 97205-1902
(503) 221-0161
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1035732
OR
225X00000X
Occupational Therapist
4605
NC
Other
Enumeration date
04/29/2008
Last updated
12/29/2020
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