Individual
HEIDI KAE MORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5135 SKYLINE RD S, SALEM, OR 97306-9427
(503) 370-4311
Mailing address
5135 SKYLINE RD S, SALEM, OR 97306
(503) 370-4311
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
OR
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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