Individual
HEATHER RENAE WETCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(707) 815-2700
Mailing address
17013 NW JOHNSON RD, HILLSBORO, OR 97124-9216
(707) 815-2700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
10975813-1206
UT
363AM0700X
Medical Physician Assistant
Primary
PA204085
OR
Other
Enumeration date
09/12/2018
Last updated
10/13/2021
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