Individual
MS. HEATHER CONROY SELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
5050 NE HOYT ST., SUITE B55, PORTLAND, OR 97213-2984
(503) 233-5393
(503) 659-8984
Mailing address
5050 NE HOYT ST., SUITE B55, PORTLAND, OR 97213-2984
(503) 233-5393
(503) 659-8984
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
093006586N2
OR
2080A0000X
Pediatric Adolescent Medicine Physician
93006586NZ
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500639814
—
OR
Enumeration date
06/20/2008
Last updated
02/27/2012
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