Individual provider · Type 1 NPI

Elaine Prendiville Heaton, MEDICAL STUDENT

Student in an Organized Health Care Education/Training Program · Portland, OR

NPI number 1861075764 Active

Practice location

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

Call (503) 494-8311 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1861075764

Elaine Prendiville Heaton, MEDICAL STUDENT's National Provider Identifier is 1861075764, issued on Apr 29, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, OR. The record was last updated on Sep 28, 2026.