| Heather Teters Llc | |
|
1234 Ne 75th Ave Portland OR 97213-6127 | |
| (503) 799-0065 | |
| Not Available |
| Full Name | Heather Teters Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1234 Ne 75th Ave, Portland, Oregon |
| Authorized Official Name and Position | Heather Teters (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5037990065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heather Teters Llc 1234 Ne 75th Ave Portland OR 97213-6127 Ph: (503) 799-0065 | Heather Teters Llc 1234 Ne 75th Ave Portland OR 97213-6127 Ph: (503) 799-0065 |
| NPI Number | 1386269686 |
|---|---|
| Provider Enumeration Date | 06/11/2020 |
| Last Update Date | 09/06/2023 |
| Certification Date | 06/11/2020 |
| Medicare PECOS PAC ID | 6204246051 |
|---|---|
| Medicare Enrollment ID | O20201105001286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386269686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Heather M Teters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497030431 PECOS PAC ID: 3971864349 Enrollment ID: I20201105001402 |
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