Individual
TAMMY ALYCE HESKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2801 N GANTENBEIN AVE, DEPT OF PEDIATRICS, PORTLAND, OR 97227-1623
(503) 413-2042
(503) 413-2566
Mailing address
2801 N GANTENBEIN AVE, DEPT OF PEDIATRICS, PORTLAND, OR 97227-1623
(503) 413-2042
(503) 413-2566
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD15616
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065628
—
OR
Enumeration date
07/16/2006
Last updated
07/08/2007
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