Individual
HEIDI A MASANGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
9405 SW 153RD AVE, BEAVERTON, OR 97007-8863
(503) 716-8669
Mailing address
9405 SW 153RD AVE, BEAVERTON, OR 97007-8863
(503) 716-8669
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
201141552RN
OR
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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