Provider Demographics
NPI:1740169382
Name:IVES, HEATHER BRIDGHAM (DPT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:BRIDGHAM
Last Name:IVES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:BRIDGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4660 MAIN ST STE 600-1
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-4021
Mailing Address - Country:US
Mailing Address - Phone:541-683-5187
Mailing Address - Fax:541-689-4525
Practice Address - Street 1:4660 MAIN ST STE 600-1
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-4021
Practice Address - Country:US
Practice Address - Phone:541-683-5187
Practice Address - Fax:541-689-4525
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist