Provider Demographics
NPI:1114394186
Name:WALCHLI, DONNA VIE (RDH)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:VIE
Last Name:WALCHLI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6665 DELMONICO DR
Mailing Address - Street 2:STE C
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-6801
Mailing Address - Country:US
Mailing Address - Phone:719-599-5700
Mailing Address - Fax:
Practice Address - Street 1:6665 DELMONICO DR
Practice Address - Street 2:STE C
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-6801
Practice Address - Country:US
Practice Address - Phone:719-599-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO905473124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist