MEDICARE: DR. HEIDI BREITBEIL ND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	NT00000813	WA

General Provider Information

NPI Number	:	1982630190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEIDI BREITBEIL ND

Provider Business Mailing Address
First Line	:	31 HI WAY
Second Line	:
City	:	WINTHROP
State	:	WA
Zip	:	98862-9606
Country	:	US
Telephone Number	:	509-996-3970
Fax Number	:	509-996-3971

Provider Business Practice Location Address
First Line	:	105 NORFOLK RD
Second Line	:
City	:	WINTHROP
State	:	WA
Zip	:	98862-9165
Country	:	US
Telephone Number	:	509-996-3970
Fax Number	:	509-996-3971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	02/15/2013

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