Provider Demographics
NPI:1538338777
Name:HAYWOOD, ASHLEY (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:HAYWOOD
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7931 SE WOODWARD ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-1714
Mailing Address - Country:US
Mailing Address - Phone:503-320-2706
Mailing Address - Fax:
Practice Address - Street 1:125 NE KILLINGSWORTH ST
Practice Address - Street 2:SUITE #101
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-2664
Practice Address - Country:US
Practice Address - Phone:503-320-2706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01124171100000X
OR1609175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist