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NPI Code Detail

MEDICARE: HEATHER DIAZ

MEDICARE: HEATHER DIAZ
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
1207Q00000XFamily Medicine PhysicianMD26534OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255322269
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER DIAZ
Provider Business Mailing Address
First Line : 255 LANCASTER DR NE
Second Line :
City : SALEM
State : OR
Zip : 97301-5155
Country : US
Telephone Number : 503-576-8400
Fax Number : 503-364-0775
Provider Business Practice Location Address
First Line : 255 LANCASTER DR NE
Second Line :
City : SALEM
State : OR
Zip : 97301-5155
Country : US
Telephone Number : 503-576-8400
Fax Number : 503-364-0775
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 03/17/2021

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Directions to “ HEATHER DIAZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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