Provider Demographics
NPI:1447655535
Name:PENDELL, MICHAEL TODD (ND)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TODD
Last Name:PENDELL
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 N VILLA RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1855
Mailing Address - Country:US
Mailing Address - Phone:503-726-8135
Mailing Address - Fax:
Practice Address - Street 1:434 N VILLA RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1855
Practice Address - Country:US
Practice Address - Phone:503-726-8135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-31
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2057175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR2057OtherOREGON LICENSE