Individual
HEIDI LOUISA OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, QMHA
Contact information
Practice address
5624 SW BRUGGER ST, PORTLAND, OR 97219-4904
(503) 245-2961
Mailing address
5624 SW BRUGGER ST, PORTLAND, OR 97219-4904
(503) 245-2961
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
OR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/24/2007
Last updated
09/11/2025
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