Healthcare Provider Details

I. General information

NPI: 1386843159
Provider Name (Legal Business Name): HEIDI TORNBERG D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 DEBORAH RD SUITE 270
NEWBERG OR
97132-2198
US

IV. Provider business mailing address

700 DEBORAH RD SUITE 270
NEWBERG OR
97132-2198
US

V. Phone/Fax

Practice location:
  • Phone: 503-538-5433
  • Fax: 503-537-5153
Mailing address:
  • Phone: 503-538-5433
  • Fax: 503-537-5153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3752
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: