Provider Demographics
NPI:1114114329
Name:FERCHOFF, RYAN DALE (ND)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DALE
Last Name:FERCHOFF
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 1:2752 WOODLAWN DR
Mailing Address - Street 2:SUITE 5-110
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1855
Mailing Address - Country:US
Mailing Address - Phone:808-988-0800
Mailing Address - Fax:
Practice Address - Street 1:125 KALLOF PL
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5566
Practice Address - Country:US
Practice Address - Phone:808-988-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND-153175F00000X
AZ03-727175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath