Provider Demographics
NPI:1104657634
Name:SON, HELENA HEEJOUNG (FNP-C)
Entity type:Individual
Prefix:
First Name:HELENA
Middle Name:HEEJOUNG
Last Name:SON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 NE 131ST PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-3205
Mailing Address - Country:US
Mailing Address - Phone:541-288-3730
Mailing Address - Fax:
Practice Address - Street 1:1235 NE 131ST PL
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-3205
Practice Address - Country:US
Practice Address - Phone:541-288-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10030532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily