Heidi Lynn Wise

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA184479 Issued in OR

Practice address

850 SW 26TH St
Corvallis, OR 97331-8624

Phone

(541) 737-9355

NPI assigned

Jul 1, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Heidi Lynn Thramer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oregon State University Student Health Services

  • Student Health Clinic/Center
  • Corvallis, OR
  • NPI 1316048531
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1689195414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 BERGMAN PL SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973179384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SW 26TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318624",
            "telephone_number": "541-737-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "HEIDI",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-01",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000001491",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA184479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "THRAMER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katie Winningham
• Sydney Winstead, PT, DPT, ATC
• Kimberly Sue Winter
• Marie Nelson Winterscheid, P.T.
• Robert B Wirth, M.D.
• Brooke Wittrock
• Ronald D Wobig, MD
• James Scott Woerner
• Emelyne M Woessner, PSY.D.
• Abigail Wojcikiewicz, N.D.

• Medical Physician Assistant in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.