Individual
TERESA HEESACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
18907 PORTLAND AVE, GLADSTONE, OR 97027-1630
(503) 850-4298
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 850-4298
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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