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NPI Code Detail

MEDICARE: ELIZABETH HEINRICH

MEDICARE: ELIZABETH HEINRICH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1205768744
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH HEINRICH
Provider Business Mailing Address
First Line : 200 MULLINS DR
Second Line :
City : LEBANON
State : OR
Zip : 97355-3983
Country : US
Telephone Number : 541-259-0235
Fax Number :
Provider Business Practice Location Address
First Line : 200 MULLINS DR
Second Line :
City : LEBANON
State : OR
Zip : 97355-3983
Country : US
Telephone Number : 541-259-0235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ ELIZABETH HEINRICH ” Practice Location

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