Provider Demographics
NPI:1346563426
Name:SCHOPEN, HEIDI K (LMT)
Entity Type:Individual
Prefix:MISS
First Name:HEIDI
Middle Name:K
Last Name:SCHOPEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 NE 70TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-5507
Mailing Address - Country:US
Mailing Address - Phone:503-380-1106
Mailing Address - Fax:
Practice Address - Street 1:445 NE 70TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-5507
Practice Address - Country:US
Practice Address - Phone:503-380-1106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13114174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist