Individual
NATHAN HEYDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1110 SE ALDER ST, PORTLAND, OR 97214-2400
(503) 932-2582
Mailing address
466 E GREEN ST, WESTMINSTER, MD 21157-5624
(240) 818-4461
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
R5582
OR
Other
Enumeration date
10/26/2018
Last updated
02/01/2022
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