Healthcare Provider Details

I. General information

NPI: 1174457386
Provider Name (Legal Business Name): ELLI REILANDER ND
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78097 COBALT CT
LA QUINTA CA
92253-3821
US

IV. Provider business mailing address

784 ALGET AVE
MILL BAY BC
V8H1B1
CA

V. Phone/Fax

Practice location:
  • Phone: 236-844-2206
  • Fax: 236-912-2023
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1632
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: