Provider Demographics
NPI:1972813624
Name:WAICHUNAS, DANA EVE (ND)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:EVE
Last Name:WAICHUNAS
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 1:1330 SE 39TH AVE.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214
Mailing Address - Country:US
Mailing Address - Phone:503-232-1100
Mailing Address - Fax:503-232-7751
Practice Address - Street 1:1330 SE 39TH AVE.
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214
Practice Address - Country:US
Practice Address - Phone:503-232-1100
Practice Address - Fax:503-232-7751
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1756175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath