Individual
EMILY HEIBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 PACIFIC AVE, FOREST GROVE, OR 97116-2226
(503) 359-0449
Mailing address
6805 SW NYBERG ST APT E304, TUALATIN, OR 97062-8333
(541) 992-2521
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1009851
OR
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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