Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | OP60419714 | WA |
NPI | 1235364340 |
---|---|
Provider Name | Heather Mikes |
First Address | Portland, OR 97208-2077 |
Second Address | Vancouver, WA 98686-2742 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2009 |
Last Update Date | 24/05/2021 |