Individual
HEIDI SUSANNE DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
29345 SW TOWN CENTER LOOP E, SUITE 110, WILSONVILLE, OR 97070-8486
(503) 582-2100
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01447
OR
363AM0700X
Medical Physician Assistant
PA652
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500609968
—
OR
Enumeration date
01/16/2007
Last updated
10/23/2025
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