Provider Demographics
NPI:1649082678
Name:HEART OF THE VALLEY GYNECOLOGY AND SEXUAL HEALTH
Entity type:Organization
Organization Name:HEART OF THE VALLEY GYNECOLOGY AND SEXUAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEGELT HEINZ
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CNM
Authorized Official - Phone:541-602-1165
Mailing Address - Street 1:1120 NW ALDER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-9102
Mailing Address - Country:US
Mailing Address - Phone:541-602-1165
Mailing Address - Fax:
Practice Address - Street 1:2211 NW PROFESSIONAL DR STE 202
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3892
Practice Address - Country:US
Practice Address - Phone:541-919-5778
Practice Address - Fax:541-229-5202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty