Healthcare Provider Details

I. General information

NPI: 1376173260
Provider Name (Legal Business Name): HEIDI MCGREAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2020
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2104 SE MORRISON ST
PORTLAND OR
97214-2825
US

IV. Provider business mailing address

1943 NW IRVING ST APT 206
PORTLAND OR
97209-1238
US

V. Phone/Fax

Practice location:
  • Phone: 971-285-6545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC7780
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: