Healthcare Provider Details

I. General information

NPI: 1861300675
Provider Name (Legal Business Name): HEATHER SELLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16506 SE SLATE ST
DAMASCUS OR
97089-9123
US

IV. Provider business mailing address

16506 SE SLATE ST
DAMASCUS OR
97089-9123
US

V. Phone/Fax

Practice location:
  • Phone: 503-522-0485
  • Fax:
Mailing address:
  • Phone: 503-522-0485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number201505636RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: