Individual
HEATHER ISHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHP-R
Contact information
Practice address
3867 WOLVERINE ST NE BLDG F, SALEM, OR 97305-4266
(503) 588-5352
Mailing address
3867 WOLVERINE ST NE BLDG F, SALEM, OR 97305-4266
(503) 588-5352
(503) 585-4990
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OR
Other
Enumeration date
06/13/2025
Last updated
06/13/2025
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