NPI 1821139155 · live from the CMS NPI Registry
Heidi R Boersma, O.D.
Optometrist in Portland, OR. National Provider Identifier 1821139155, active.
NPI record
| NPI | 1821139155 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 2300 Ne Broadway St, Portland, OR 97232 |
| Practice phone | 503-284-2300 |
| Enumerated | February 9, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 2721ATI (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.