Healthcare Provider Details

I. General information

NPI: 1295651800
Provider Name (Legal Business Name): PACIFIC NORTHWEST HAIR RESTORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9735 SW SHADY LN STE 200
TIGARD OR
97223-5481
US

IV. Provider business mailing address

2450 NE MARY ROSE PL STE 205
BEND OR
97701-7132
US

V. Phone/Fax

Practice location:
  • Phone: 503-941-5029
  • Fax: 503-941-5029
Mailing address:
  • Phone: 541-749-7000
  • Fax: 541-749-7005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW PATRICK HIGGINS
Title or Position: OWNER/PROVIDER
Credential: MD
Phone: 541-480-6612