Individual
HEATHER ANN HACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDM, CPM
Contact information
Practice address
2620 SE 51ST AVE, PORTLAND, OR 97206-1414
(503) 504-0885
(503) 914-1862
Mailing address
2620 SE 51ST AVE, PORTLAND, OR 97206-1414
(503) 504-0885
(503) 914-1862
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEM-LM-1008799
OR
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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