Healthcare Provider Details

I. General information

NPI: 1669978367
Provider Name (Legal Business Name): EDEN EPSTEIN HILL PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 04/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 MILLER AVE STE 273
MILL VALLEY CA
94941-1903
US

IV. Provider business mailing address

6224 SE 55TH AVE
PORTLAND OR
97206-6800
US

V. Phone/Fax

Practice location:
  • Phone: 415-302-3651
  • Fax:
Mailing address:
  • Phone: 503-730-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: