Provider Demographics
NPI:1942322441
Name:COSTELLO, HILARY PAIGE (ND)
Entity Type:Individual
Prefix:DR
First Name:HILARY
Middle Name:PAIGE
Last Name:COSTELLO
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 1:9404 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-4819
Mailing Address - Country:US
Mailing Address - Phone:503-246-0513
Mailing Address - Fax:
Practice Address - Street 1:16524 BOONES FERRY RD APT 202
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-4280
Practice Address - Country:US
Practice Address - Phone:503-272-1679
Practice Address - Fax:877-732-9555
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1482175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath