Provider Demographics
NPI:1164437679
Name:SOMMER, HEIKE (PMHNP)
Entity Type:Individual
Prefix:
First Name:HEIKE
Middle Name:
Last Name:SOMMER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 SW MORRISON ST STE 535
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2239
Mailing Address - Country:US
Mailing Address - Phone:503-504-6999
Mailing Address - Fax:
Practice Address - Street 1:1220 SW MORRISON ST STE 535
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2239
Practice Address - Country:US
Practice Address - Phone:503-504-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR096000127RN363LP0808X
OR200350148NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR277957Medicaid
Q06888Medicare UPIN