Provider Demographics
NPI:1265462352
Name:HALSETH, HEATHER RUTH (ATC/R)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RUTH
Last Name:HALSETH
Suffix:
Gender:F
Credentials:ATC/R
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:R
Other - Last Name:GARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC/R
Mailing Address - Street 1:2727 LEO HARRIS PKWY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8835
Mailing Address - Country:US
Mailing Address - Phone:541-346-2257
Mailing Address - Fax:855-850-1265
Practice Address - Street 1:1590 EAST 13TH AVE
Practice Address - Street 2:CLINIC B
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403
Practice Address - Country:US
Practice Address - Phone:541-346-4470
Practice Address - Fax:855-850-1265
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAT-AT-10068862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer