Provider Demographics
NPI:1104511799
Name:HEFFRON, ALLYSON PAIGE
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:PAIGE
Last Name:HEFFRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALLY
Other - Middle Name:PAIGE
Other - Last Name:HEFFRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:84287 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:OR
Mailing Address - Zip Code:97455-9710
Mailing Address - Country:US
Mailing Address - Phone:541-790-9435
Mailing Address - Fax:
Practice Address - Street 1:37875 JASPER LOWELL RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:OR
Practice Address - Zip Code:97438-9751
Practice Address - Country:US
Practice Address - Phone:541-747-1235
Practice Address - Fax:541-747-4722
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health