Provider Demographics
NPI:1184047334
Name:ELIZABETH D. DASHER, SA, LLC
Entity type:Organization
Organization Name:ELIZABETH D. DASHER, SA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:DASHER
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:970-371-6277
Mailing Address - Street 1:7038 HONEYCOMB DR
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-5041
Mailing Address - Country:US
Mailing Address - Phone:970-371-6277
Mailing Address - Fax:
Practice Address - Street 1:7038 HONEYCOMB DR
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-5041
Practice Address - Country:US
Practice Address - Phone:970-371-6277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty