MEDICARE: HEATHER LOBITZ CD(DONA)

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	374J00000X	Doula

General Provider Information

NPI Number	:	1942612353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER LOBITZ CD(DONA)

Provider Business Mailing Address
First Line	:	PO BOX 83407
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97283-0407
Country	:	US
Telephone Number	:	971-226-4061
Fax Number	:

Provider Business Practice Location Address
First Line	:	9008 N SAINT JOHNS AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-1563
Country	:	US
Telephone Number	:	971-226-4061
Fax Number	:

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

Provider Enumeration Date	:	05/20/2014
Last Update Date	:	05/20/2014

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Directions to “ HEATHER LOBITZ CD(DONA)” Practice Location

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