Provider Demographics
NPI:1215304019
Name:SEARGEANT, HEATHER CRYSTAL (BSP)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:CRYSTAL
Last Name:SEARGEANT
Suffix:
Gender:F
Credentials:BSP
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:CRYSTAL
Other - Last Name:MINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSP
Mailing Address - Street 1:12525 SE EASTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-8622
Mailing Address - Country:US
Mailing Address - Phone:707-841-1142
Mailing Address - Fax:
Practice Address - Street 1:845 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLITS
Practice Address - State:CA
Practice Address - Zip Code:95490-3915
Practice Address - Country:US
Practice Address - Phone:707-456-1790
Practice Address - Fax:707-456-1794
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-000178661835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist