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Contact Information

HEIDI J HANSEN, DMD
4805 NE GLISAN ST STE 11N
PORTLAND, OR97213-2933
 Phone: 503-215-1676
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral Medicinist

125Q00000X
 

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for HEIDI J HANSEN · (Female)

NPI Number 1063655967
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 04/08/2009
Last updated 10/23/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 055295
  • OR License # D11216
Hospital affiliation(s)
  • PROVIDENCE PORTLAND MEDICAL CENTER - (Acute Care)
    4805 NE GLISAN STREET
    PORTLAND, OR 97213
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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