Individual
HEIDI VON BROCKDORFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DIPL.OM, L.AC.
Contact information
Practice address
1400 EXECUTIVE PKWY STE 245, EUGENE, OR 97401-2197
(970) 250-0940
Mailing address
502 WEDGEWOOD DR, EUGENE, OR 97404-3539
(970) 250-0940
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1144
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC156947
STATE MEDICAL LICENSE
OR
Enumeration date
04/06/2006
Last updated
11/14/2018
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