Provider Demographics
NPI:1780950238
Name:BEHRENDS, HEIDI T (RN BSN IBCLC)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:T
Last Name:BEHRENDS
Suffix:
Gender:F
Credentials:RN BSN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 CHARNELTON ST
Mailing Address - Street 2:SUITE #7
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6214
Mailing Address - Country:US
Mailing Address - Phone:541-556-4240
Mailing Address - Fax:
Practice Address - Street 1:1245 CHARNELTON ST
Practice Address - Street 2:SUITE #7
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6214
Practice Address - Country:US
Practice Address - Phone:541-556-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR087006822RN163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant