Provider Demographics
NPI:1003191313
Name:HEINE, AARON MICHAEL (BA)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:MICHAEL
Last Name:HEINE
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 SE HIGHWAY 212
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9165
Mailing Address - Country:US
Mailing Address - Phone:503-655-8045
Mailing Address - Fax:503-655-6806
Practice Address - Street 1:10810 SE HIGHWAY 212
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9165
Practice Address - Country:US
Practice Address - Phone:503-655-8045
Practice Address - Fax:503-655-6806
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor