Individual
MS. HEATHER CASEBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
11782 SW BARNES RD STE 100, PORTLAND, OR 97225-5931
(503) 906-4323
(503) 906-6613
Mailing address
11782 SW BARNES RD, STE 300, PORTLAND, OR 97225-5933
(503) 906-4323
(503) 906-6616
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4267
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4267
PT LICENSE
OR
Enumeration date
06/26/2006
Last updated
11/18/2021
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