Heather Greene LLC
Community/Behavioral Health in Beaverton, OR. Organization (NPI-2).
NPI number1215463518
StatusActive
Last updated in NPPESMay 4, 2017
Details
- NPI
- 1215463518
- Entity type
- Organization (NPI-2)
- Legal business name
- Heather Greene LLC
- Organization subpart
- No
- Enumeration date
- May 4, 2017
- Last updated
- May 4, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | L4691 | OR | Yes |
Practice location
12555 Sw 1st StBeaverton, OR 97005-0546
Phone 971-724-7393
Mailing address
18005 Sw Ewen DrBeaverton, OR 97003-3818
Phone 971-724-7393
Authorized official
Heather Greene
Owner
9717247393
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