Individual
LYDIA JUSTINE HEFFERON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
15455 NW GREENBRIER PKWY STE 200, BEAVERTON, OR 97006-7359
(503) 258-4631
Mailing address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 258-4200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
A14022
OR
Other
Enumeration date
01/09/2023
Last updated
04/07/2023
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