Individual
HEATHER ONTIVEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4544 SE HAIG ST, PORTLAND, OR 97206-3119
(503) 888-6205
Mailing address
4544 SE HAIG ST, PORTLAND, OR 97206-3119
(503) 888-6205
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
096000579RN
OR
Other
Enumeration date
01/31/2014
Last updated
01/31/2014
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