Individual
HEATHER VAN HOUTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12540 SW MAIN ST STE 202, TIGARD, OR 97223
(503) 292-7005
(503) 292-9058
Mailing address
12540 SW MAIN ST STE 202, TIGARD, OR 97223-6198
(503) 906-9995
(503) 597-7000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA178100
OR
Other
Enumeration date
06/08/2016
Last updated
05/14/2018
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