Provider Demographics
NPI:1780135939
Name:DHUNGANA, ELIZABETH LOUISE (CNP)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:DHUNGANA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 VALLEY RIVER DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2116
Mailing Address - Country:US
Mailing Address - Phone:605-881-3810
Mailing Address - Fax:
Practice Address - Street 1:3915 RIVER RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-1230
Practice Address - Country:US
Practice Address - Phone:541-688-9140
Practice Address - Fax:541-689-0049
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201701159NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500726060Medicaid