Healthcare Provider Details

I. General information

NPI: 1780424960
Provider Name (Legal Business Name): HEIDI JO POLLARD-HERMANN MA, MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

11760 SW CAMPBELL RD
HILLSBORO OR
97123-9017
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-7534
  • Fax:
Mailing address:
  • Phone: 619-920-4078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number201141309RN
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10046531
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: