Provider Demographics
NPI:1679725766
Name:RICHARDS, DARIELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DARIELLE
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DARIELLE
Other - Middle Name:
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2897 MAPLELEAF CT NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-1335
Mailing Address - Country:US
Mailing Address - Phone:503-991-5492
Mailing Address - Fax:503-991-5483
Practice Address - Street 1:2897 MAPLELEAF CT NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-1335
Practice Address - Country:US
Practice Address - Phone:503-991-5492
Practice Address - Fax:503-991-5483
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORN/A174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1679725766OtherNO LONGER ACCEPTING INSURANCE