Provider Demographics
NPI:1700188935
Name:PHILLIPS, HEATHER L (LSCW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:BABBITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7650 SW BEVELAND RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8692
Mailing Address - Country:US
Mailing Address - Phone:503-601-3615
Mailing Address - Fax:503-646-1683
Practice Address - Street 1:7431 NE EVERGREEN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5831
Practice Address - Country:US
Practice Address - Phone:503-840-3400
Practice Address - Fax:503-840-3409
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602486971041C0700X
ORL79331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical