Provider Demographics
NPI:1326252602
Name:WADDELL, SHAYLA MARIE (ND)
Entity Type:Individual
Prefix:DR
First Name:SHAYLA
Middle Name:MARIE
Last Name:WADDELL
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 1:56 COMMONWEALTH CT
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-8245
Mailing Address - Country:US
Mailing Address - Phone:530-513-6199
Mailing Address - Fax:480-248-3571
Practice Address - Street 1:56 COMMONWEALTH CT
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-8245
Practice Address - Country:US
Practice Address - Phone:530-513-6199
Practice Address - Fax:480-248-3571
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND 230175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath