Healthcare Provider Details

I. General information

NPI: 1437451093
Provider Name (Legal Business Name): JAMES ISAAC HETHERINGTON ND, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2010
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 OREGON AVE
ERIE PA
16505-3817
US

IV. Provider business mailing address

620 OREGON AVE
ERIE PA
16505-3817
US

V. Phone/Fax

Practice location:
  • Phone: 206-290-2176
  • Fax:
Mailing address:
  • Phone: 206-290-2176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00161756
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN532138
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60183537
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: