Provider Demographics
NPI:1952854622
Name:HIGGINS, HEATHER (CCC-SLP, MS)
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:CCC-SLP, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4018 N MISSISSIPPI AVE APT 407
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1699
Mailing Address - Country:US
Mailing Address - Phone:503-810-9846
Mailing Address - Fax:
Practice Address - Street 1:4018 N MISSISSIPPI AVE APT 407
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1699
Practice Address - Country:US
Practice Address - Phone:503-810-9846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60392797235Z00000X
HISP 1395235Z00000X
OR014088235Z00000X
CASP 22067235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist