Individual provider · Type 1 NPI

Jesse Edward Vander Heide

Ambulatory Care Registered Nurse · Portland, OR

NPI number 1083240295 Active

Practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Call (503) 494-3273 Map

Mailing address

4230 SW Chesapeak Ave
Portland, OR 97239-1345

Specialties and licenses

Taxonomy	Code	License
Ambulatory Care Registered Nurse Primary	163WP2201X	200441630RN (OR)

Ambulatory Care Registered Nurse: Definition to come...

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About NPI 1083240295

Jesse Edward Vander Heide's National Provider Identifier is 1083240295, issued on Mar 19, 2020. The primary taxonomy on file is Ambulatory Care Registered Nurse (163WP2201X), and the practice location is in Portland, OR. The record was last updated on Mar 19, 2020.