Provider Demographics
NPI:1427529817
Name:JAMI HEYTING, ND, LLC
Entity type:Organization
Organization Name:JAMI HEYTING, ND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:HEYTING
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:541-316-0468
Mailing Address - Street 1:2130 SW CANYON DR APT D
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-0328
Mailing Address - Country:US
Mailing Address - Phone:541-316-0468
Mailing Address - Fax:
Practice Address - Street 1:818 SW FOREST AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2737
Practice Address - Country:US
Practice Address - Phone:541-316-0468
Practice Address - Fax:833-643-0179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500724147Medicaid