Healthcare Provider Details

I. General information

NPI: 1114023348
Provider Name (Legal Business Name): HEATHER GAY BOYD ROBERTS ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER GAY ROBERTS ND

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8513 NE HAZEL DELL AVE 203
VANCOUVER WA
98665
US

IV. Provider business mailing address

8513 NE HAZEL DELL AVE 203
VANCOUVER WA
98665
US

V. Phone/Fax

Practice location:
  • Phone: 360-573-2273
  • Fax: 360-573-4780
Mailing address:
  • Phone: 360-573-2273
  • Fax: 360-573-4780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number708
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: