Provider Demographics
NPI:1114023348
Name:BOYD ROBERTS, HEATHER GAY (ND)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:GAY
Last Name:BOYD ROBERTS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:GAY
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:8513 NE HAZEL DELL AVE
Mailing Address - Street 2:203
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665
Mailing Address - Country:US
Mailing Address - Phone:360-573-2273
Mailing Address - Fax:360-573-4780
Practice Address - Street 1:8513 NE HAZEL DELL AVE
Practice Address - Street 2:203
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665
Practice Address - Country:US
Practice Address - Phone:360-573-2273
Practice Address - Fax:360-573-4780
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA708175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath