Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0004X | Health Psychologist |
NPI | 1629482674 |
---|---|
Provider Name | Heather Hopson |
First Address | Portland, OR 97229-5442 |
Second Address | Portland, OR 97229-5442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2014 |
Last Update Date | 18/06/2014 |