Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 991 | OR |
NPI | 1114003282 |
---|---|
Provider Name | Dr. Heidi Belinda Peterson |
First Address | Portland, OR 97214-5243 |
Second Address | Portland, OR 97214-5243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 17/04/2015 |