Individual
HEIDI THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3095
(503) 221-3718
Mailing address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3095
(503) 221-3718
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-000801
OR
Other
Enumeration date
03/04/2021
Last updated
03/04/2021
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