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KEVIN HEIDRICK P.A.-C
NPI 1891884268
Physician Assistant - Medical in Woodburn, OR

Active since October 12, 2006
1175 MOUNT HOOD AVENUE, WOODBURN, OR 97071(503) 982-2000(503) 982-0660 Get Directions Write a Review

NPPES record last updated: December 20, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kevin Heidrick P.a.-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN HEIDRICK P.A.-C (NPI 1891884268) is an individual medical provider in Woodburn, Oregon, licensed in Oregon (PA00369) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1891884268
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameKEVIN HEIDRICKCredential: P.A.-C
Location Address1175 MOUNT HOOD AVENUEWoodburn, OR 97071
Mailing AddressPo Box 190Toppenish, WA 98948-0190 · (509) 865-5898
Phone(503) 982-2000
Fax(503) 982-0660
Sole ProprietorNo
Enumeration DateOctober 12, 2006
Last NPPES UpdateDecember 20, 2012
✔ NPI 1891884268 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in OR · PA00369
1175 MOUNT HOOD AVENUE, Woodburn, OR 97071
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Other Identifiers 6

Medicare ID-Type UnspecifiedR109784
Medicare ID-Type UnspecifiedP00069843Rr Medicare
Other911019392Commercial
OtherM066501Pacific Source
Medicare UPINP34411
Other067463016OR · Regence

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK MULLENBACH DMD
Dentist (General Practice)
1175 MOUNT HOOD AVENUE
WOODBURN, OR 97071
Marion County (503) 982-2000
YAKIM VALLEY FARM WORKERS CLINIC
Pharmacy (Clinic Pharmacy)
1175 MOUNT HOOD AVENUE
WOODBURN, OR 97071
Marion County (503) 982-0635

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Heidrick's NPI number?

The NPI number for Kevin Heidrick is 1891884268. It was assigned to this individual provider in the NPPES registry on October 12, 2006.

Where is Kevin Heidrick located?

Kevin Heidrick practices at 1175 Mount Hood Avenue, Woodburn, OR 97071. The listed phone number is (503) 982-2000.

What is Kevin Heidrick's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Kevin Heidrick was last updated on December 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.