Healthcare Provider Details

I. General information

NPI: 1396994000
Provider Name (Legal Business Name): HEATHER M FINK MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 05/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 NE PARK LN
FAIRVIEW OR
97024-3822
US

IV. Provider business mailing address

PO BOX 444
FAIRVIEW OR
97024-0444
US

V. Phone/Fax

Practice location:
  • Phone: 503-201-6508
  • Fax:
Mailing address:
  • Phone: 503-201-6508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: