Provider Demographics
NPI:1770271116
Name:CHANDLER, DAMIAN MICHAEL
Entity type:Individual
Prefix:
First Name:DAMIAN
Middle Name:MICHAEL
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8859 SOLO WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-5536
Mailing Address - Country:US
Mailing Address - Phone:206-353-8000
Mailing Address - Fax:
Practice Address - Street 1:8859 SOLO WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-5536
Practice Address - Country:US
Practice Address - Phone:206-353-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist