MEDICARE: MRS. HEATHER NICOLE HOWARD LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	13263	OR

General Provider Information

NPI Number	:	1114135373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER NICOLE HOWARD LMT

Provider Business Mailing Address
First Line	:	1256 TRENT AVE N
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303
Country	:	US
Telephone Number	:	971-901-9008
Fax Number	:

Provider Business Practice Location Address
First Line	:	6020 WINDSOR ISLAND RD N.
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303
Country	:	US
Telephone Number	:	503-463-4653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2007
Last Update Date	:	10/09/2019

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