Provider Demographics
NPI:1013182856
Name:WAYCHOFF, ERIN LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LEE
Last Name:WAYCHOFF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2954
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85062-2954
Mailing Address - Country:US
Mailing Address - Phone:602-889-5833
Mailing Address - Fax:602-889-5834
Practice Address - Street 1:3202 E GREENWAY RD
Practice Address - Street 2:#1619
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4548
Practice Address - Country:US
Practice Address - Phone:602-284-8994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor