Provider Demographics
NPI:1982630190
Name:BREITBEIL, HEIDI (ND)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:BREITBEIL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:
Other - Last Name:BREITBEIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:31 HI WAY
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:WA
Mailing Address - Zip Code:98862-9606
Mailing Address - Country:US
Mailing Address - Phone:509-996-3970
Mailing Address - Fax:509-996-3971
Practice Address - Street 1:105 NORFOLK RD
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:WA
Practice Address - Zip Code:98862-9165
Practice Address - Country:US
Practice Address - Phone:509-996-3970
Practice Address - Fax:509-996-3971
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000813175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath