Individual
MARK B HEINONEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10180 SE SUNNYSIDE RD, SUNNYSIDE MEDICAL CENTER, CLACKAMAS, OR 97015-8970
(503) 652-2880
Mailing address
10180 SE SUNNYSIDE RD, SUNNYSIDE MEDICAL CENTER, CLACKAMAS, OR 97015-8970
(503) 652-2880
(702) 558-1522
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
10173
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200211519
—
NV
Enumeration date
08/11/2005
Last updated
02/04/2022
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