Long, Heather Beth
Long, Heather Beth is an individual health care provider with primary practice located at 15970 Se Misty Dr Ste 100 , Happy Valley OR 97086-4368. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Long, Heather Beth can be contacted via phone (503) 427-2637.Contact Information
Primary practice address
15970 Se Misty Dr Ste 100
Happy Valley OR 97086-4368
Phone: (503) 427-2637
Fax: (503) 659-8984
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 2007017298 | Missouri |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD151090 | Oregon |
Profile Details
| NPI number | 1194923862 |
|---|---|
| LBN Legal business name | Long, Heather Beth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 4th, 2007 |
| Last updated | May 20th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194923862 | NPPES |
| Oregon | MEDICAID | 500624770 |
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