MEDICARE: MRS. HEATHER MARIE MCLEAN N.P.

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	363L00000X	Nurse Practitioner	089003393RN	OR
2	363L00000X	Nurse Practitioner	200850106NP-PP	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1932392107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER MARIE MCLEAN N.P.

Provider Business Mailing Address
First Line	:	2111 EXCHANGE ST
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-3329
Country	:	US
Telephone Number	:	503-325-4321
Fax Number	:

Provider Business Practice Location Address
First Line	:	2095 EXCHANGE ST STE 301
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-3400
Country	:	US
Telephone Number	:	503-338-4087
Fax Number	:	503-338-4091

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

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	02/23/2022

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