Individual provider · Type 1 NPI

Heather Fogg

Mental Health Counselor · Beaverton, OR

NPI number 1255700134 Active

Practice location

1500 NW Bethany Blvd, Suite 320
Beaverton, OR 97006-5208

Mailing address

PO Box 82819
Portland, OR 97282-0819

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1255700134

Heather Fogg's National Provider Identifier is 1255700134, issued on Sep 21, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Beaverton, OR. The record was last updated on Sep 21, 2015.