Provider Demographics
NPI:1700436367
Name:PASCHALL, DANIELLE ROCHE (DNP, ARNP, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ROCHE
Last Name:PASCHALL
Suffix:
Gender:F
Credentials:DNP, ARNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 PEERLESS RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-9063
Mailing Address - Country:US
Mailing Address - Phone:253-904-4138
Mailing Address - Fax:253-323-1011
Practice Address - Street 1:510 E MAIN STE D
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-5612
Practice Address - Country:US
Practice Address - Phone:253-904-4138
Practice Address - Fax:253-323-1011
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61004475363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health