Individual
BETTY FORD HIATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
2700 NW STEWART PKWY, ROSEBURG, OR 97471-1281
(541) 667-0611
Mailing address
120 KESTREL LN, ROSEBURG, OR 97471-7840
(541) 677-3382
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
OR
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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