Individual
DR. HEIDI GOETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
425 SW ALDERIDGE DR, PORTLAND, OR 97225-6449
(503) 292-5624
(503) 297-4714
Mailing address
425 SW ALDERIDGE DR, PORTLAND, OR 97225-6449
(503) 292-5624
(503) 297-4714
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD15962
OR
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
MD15962
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050041429
RR MEDICARE
OR
05
—
068973
—
OR
05
—
1051523
—
WA
05
—
1376519207
—
MT
05
—
MD244OR
—
AK
05
—
XPY197514
—
CA
Enumeration date
02/28/2006
Last updated
10/01/2016
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