Provider Demographics
NPI:1457446775
Name:HEINITZ, ELLEN LEIGH-DAY (ND)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:LEIGH-DAY
Last Name:HEINITZ
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 1:620 SE OAK ST STE E
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4160
Mailing Address - Country:US
Mailing Address - Phone:503-747-3096
Mailing Address - Fax:503-747-3735
Practice Address - Street 1:620 SE OAK ST STE E
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4160
Practice Address - Country:US
Practice Address - Phone:503-747-3096
Practice Address - Fax:503-747-3735
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1285175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR298556OtherOMAP