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General NPI Number Information
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NPI Number | 1013854249
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Entity Type | Individual
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Provider Name | HEIDI JEAN YAICH RN
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Gender | Female
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 230 SW 3RD ST STE 304
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City | CORVALLIS
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State | OR
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Zip | 97333-4652
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Country | US
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Telephone | 541-286-8558
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Fax |
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Provider Business Mailing Address
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Address Line | 33684 MARYS RIVER ESTATES RD
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City | PHILOMATH
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State | OR
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Zip | 97370-9021
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Country | US
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Telephone | 541-286-8558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 201603096RN
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License Number State | OR
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