Provider Demographics
NPI:1154667665
Name:TUTTLE, JENNIFER (ND)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2385 NW WESTOVER RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3524
Mailing Address - Country:US
Mailing Address - Phone:503-715-7237
Mailing Address - Fax:
Practice Address - Street 1:2385 NW WESTOVER RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3524
Practice Address - Country:US
Practice Address - Phone:503-715-7237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1943175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath