Individual
HEATHER NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-7145
Mailing address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0017947
OR
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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