MEDICARE: VICTORIA L. HEINTZ R.N., L.P.C.T.

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	EPT-T-109075	OR
2	374700000X	Technician	079042335RN	OR

General Provider Information

NPI Number	:	1831340579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA L. HEINTZ R.N., L.P.C.T.

Provider Business Mailing Address
First Line	:	615 HIGH ST
Second Line	:	SUITE E
City	:	OREGON CITY
State	:	OR
Zip	:	97045-2269
Country	:	US
Telephone Number	:	503-657-0015
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 HIGH ST
Second Line	:	SUITE E
City	:	OREGON CITY
State	:	OR
Zip	:	97045-2269
Country	:	US
Telephone Number	:	503-657-0015
Fax Number	:

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

Provider Enumeration Date	:	09/30/2008
Last Update Date	:	09/30/2008

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