Provider Demographics
NPI:1437669744
Name:SWEITZER, ISABEL R (ND, LAC)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:R
Last Name:SWEITZER
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18466 SE WILLAMETTE DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-6011
Mailing Address - Country:US
Mailing Address - Phone:203-376-1246
Mailing Address - Fax:
Practice Address - Street 1:2410 SE 10TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4624
Practice Address - Country:US
Practice Address - Phone:503-966-1116
Practice Address - Fax:971-358-8084
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR171100000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist