Heather Gilliam
Community Health Worker in Portland, OR. Individual provider (NPI-1).
NPI number1053979153
StatusActive
Last updated in NPPESJun 3, 2019
Details
- NPI
- 1053979153
- Entity type
- Individual (NPI-1)
- Name
- Heather Gilliam
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 3, 2019
- Last updated
- Jun 3, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
Practice location
4400 Ne Halsey St Bldg 2Portland, OR 97213-1545
Phone 503-893-6472 · Fax 503-215-6240
Mailing address
9660 Sw Saddle DrBeaverton, OR 97008-6744
Phone 503-524-2061
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 257 Community Health Worker providers in Portland · All 48,847 providers in Portland
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