Provider Demographics
NPI:1821345679
Name:NISHIMURA, ASHLEY DANIELLE (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DANIELLE
Last Name:NISHIMURA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:DANIELLE
Other - Last Name:DOWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7362 MCLAUGHLIN RD
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4713
Mailing Address - Country:US
Mailing Address - Phone:719-358-3866
Mailing Address - Fax:719-362-4277
Practice Address - Street 1:7362 MCLAUGHLIN RD
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-4713
Practice Address - Country:US
Practice Address - Phone:719-358-3866
Practice Address - Fax:719-362-4277
Is Sole Proprietor?:No
Enumeration Date:2012-08-11
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA109023Medicare PIN