Provider Demographics
NPI:1376140418
Name:FERRIS, LANA MICHELLE (ND)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:MICHELLE
Last Name:FERRIS
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 1:2301 NE 81ST ST APT E43
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-2023
Mailing Address - Country:US
Mailing Address - Phone:360-450-5778
Mailing Address - Fax:360-450-5778
Practice Address - Street 1:1404 NE 134TH ST STE 180C
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2799
Practice Address - Country:US
Practice Address - Phone:360-450-5778
Practice Address - Fax:360-450-5778
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4356175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMF6163531OtherDEA
ORMF6772075OtherDEA