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General NPI Number Information
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NPI Number | 1457633836
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Entity Type | Individual
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Provider Name | HEATHER KIM REED FNP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2011
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3079
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Country | US
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Telephone | 503-494-8607
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3158
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City | PORTLAND
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State | OR
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Zip | 97208-3158
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60249859
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201250126NP
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License Number State | OR
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