Individual
HEIDI COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4310 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1404
(503) 535-1181
Mailing address
PO BOX 3007, DE PAUL TREATMENT CENTERS, PORTLAND, OR 97208-8097
(571) 229-0512
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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