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Individual

HEATHER M. DURHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-A

Contact information

Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(800) 452-3563
Mailing address
1111 NE TILLAMOOK, NO. 4, PORTLAND, OR 97212

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
22406
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
231983
OR
Enumeration date
09/20/2006
Last updated
07/08/2007
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