Provider Demographics
NPI:1023197472
Name:LEWIS, DANIELLE (ND)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:LEWIS
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 1:210 E MORRIS DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2323
Mailing Address - Country:US
Mailing Address - Phone:602-888-6883
Mailing Address - Fax:888-332-3861
Practice Address - Street 1:2024 N 7TH ST STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2515
Practice Address - Country:US
Practice Address - Phone:602-888-6883
Practice Address - Fax:888-332-3861
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14-1422175F00000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCND2200107OtherNATUROPATHIC PHYSICIAN
AZ14-1422OtherNATUROPATHIC PHYSICIAN
MDJ00078OtherNATUROPATHIC PHYSICIAN