Provider Demographics
NPI:1063981983
Name:WALKER, HEATHER (RDH, EPDH)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:RDH, EPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1391 MARTIN RD
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9626
Mailing Address - Country:US
Mailing Address - Phone:503-936-8422
Mailing Address - Fax:
Practice Address - Street 1:1391 MARTIN RD
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9626
Practice Address - Country:US
Practice Address - Phone:503-936-8422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH5141124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty