Provider Demographics
NPI:1326382300
Name:WINDLE, CHAUNCE R (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHAUNCE
Middle Name:R
Last Name:WINDLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3573
Mailing Address - Country:US
Mailing Address - Phone:541-580-2124
Mailing Address - Fax:541-343-2663
Practice Address - Street 1:1210 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3573
Practice Address - Country:US
Practice Address - Phone:541-580-2124
Practice Address - Fax:541-343-2663
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2292103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist