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NPI Code Detail

MEDICARE: DAVA JEAN HEATH

MEDICARE: DAVA JEAN HEATH
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
1104100000XSocial WorkerA14229OR

General Provider Information

NPI Number : 1457070047
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVA JEAN HEATH
Provider Business Mailing Address
First Line : 3400 STATE ST STE G750
Second Line :
City : SALEM
State : OR
Zip : 97301-7012
Country : US
Telephone Number : 541-900-4285
Fax Number : 888-810-2993
Provider Business Practice Location Address
First Line : 3400 STATE ST STE G750
Second Line :
City : SALEM
State : OR
Zip : 97301-7012
Country : US
Telephone Number : 503-951-6280
Fax Number : 503-468-3130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2022
Last Update Date : 04/13/2026

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Directions to “ DAVA JEAN HEATH ” Practice Location

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