Provider Demographics
NPI:1174100606
Name:NORTON, AMANDA LEIGH (ND)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEIGH
Last Name:NORTON
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 1:26360 SW CANYON CREEK RD APT 302
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-8670
Mailing Address - Country:US
Mailing Address - Phone:303-859-7667
Mailing Address - Fax:
Practice Address - Street 1:1744 SE HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-3723
Practice Address - Country:US
Practice Address - Phone:503-432-1061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61129418175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath