MEDICARE: HEATHER PENDELL ND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath		OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60986598	OTHER	WA	WASHINGTON STATE LICENSE
2	2069	OTHER	OR	OREGON LICENSE

General Provider Information

NPI Number	:	1730583352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER PENDELL ND

Provider Business Mailing Address
First Line	:	432 N VILLA RD
Second Line	:
City	:	NEWBERG
State	:	OR
Zip	:	97132-1855
Country	:	US
Telephone Number	:	971-430-1156
Fax Number	:

Provider Business Practice Location Address
First Line	:	432 N VILLA RD
Second Line	:
City	:	NEWBERG
State	:	OR
Zip	:	97132-1855
Country	:	US
Telephone Number	:	971-430-1156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2014
Last Update Date	:	12/10/2022

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Directions to “ HEATHER PENDELL ND” Practice Location

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