Fogg, Heather

Fogg, Heather is an individual health care provider with primary practice located at 1500 Nw Bethany Blvd Suite 320, Beaverton OR 97006-5208. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Fogg, Heather can be contacted via phone (503) 567-3260.

Contact Information

Primary practice address
1500 Nw Bethany Blvd Suite 320 Beaverton OR 97006-5208
Phone: (503) 567-3260
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1255700134
LBN Legal business name Fogg, Heather
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2015
Last updated Sep 21st, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255700134 NPPES
Oregon MEDICAID 164936

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