Healthcare Provider Details

I. General information

NPI: 1346038437
Provider Name (Legal Business Name): MICHELLE A HESLA MRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELLE HESLA

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 NE MARTIN LUTHER KING BLVD
PORTLAND OR
97232-2941
US

IV. Provider business mailing address

30 NE MARTIN LUTHER KING BLVD
PORTLAND OR
97232-2941
US

V. Phone/Fax

Practice location:
  • Phone: 971-230-7649
  • Fax: 971-407-2431
Mailing address:
  • Phone: 971-230-7649
  • Fax: 971-407-2431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: