Provider Demographics
NPI:1508316498
Name:NYE, HAYLEE (ND)
Entity Type:Individual
Prefix:DR
First Name:HAYLEE
Middle Name:
Last Name:NYE
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 1:5440 BAY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-6749
Mailing Address - Country:US
Mailing Address - Phone:503-583-3574
Mailing Address - Fax:855-508-2848
Practice Address - Street 1:1730 SW SKYLINE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221-2547
Practice Address - Country:US
Practice Address - Phone:503-451-5013
Practice Address - Fax:855-508-2848
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-04
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4017175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500717754Medicaid