IndividualActive
Jesse Vander Heide
NPI 1083240295 · Ambulatory Care Registered Nurse · Portland, OR
Provider details
- NPI number
- 1083240295
- Entity type
- Individual
- Primary specialty
- Ambulatory Care Registered NurseNursing Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 200441630RN (OR)
Specialties & taxonomies
Nursing Service Providers
Practice location
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-3273
Approximate (ZIP-level) locationGet directions
Mailing address
4230 Sw Chesapeak Ave
Portland, OR 97239-1345
Registry dates
- Enumerated
- 2020-03-19
- Last updated
- 2020-03-19
- Certified
- 2020-03-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.