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Individual

HEATHER DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
255 LANCASTER DR NE, SALEM, OR 97301-5155
(503) 576-8400
(503) 364-0775
Mailing address
255 LANCASTER DR NE, SALEM, OR 97301-5155
(503) 576-8400
(503) 364-0775

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD26534
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8357675
WA
Enumeration date
10/31/2005
Last updated
03/17/2021
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