Individual
MR. BENJAMIN HEARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9290 SE SUNNYBROOK BLVD STE 120, CLACKAMAS, OR 97015-6802
(503) 215-2110
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA185335
OR
Other
Enumeration date
05/31/2016
Last updated
04/26/2022
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