Provider Demographics
NPI:1982851416
Name:RICHINS, MIRANDA HEATHER
Entity Type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:HEATHER
Last Name:RICHINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MIRANDA
Other - Middle Name:HEATHER
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:324 NE AUTUMN ROSE WAY APT F
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5312
Mailing Address - Country:US
Mailing Address - Phone:503-801-5183
Mailing Address - Fax:
Practice Address - Street 1:4855 SW WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3460
Practice Address - Country:US
Practice Address - Phone:503-643-7565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy