Provider Demographics
NPI:1801322359
Name:STRIDSLAND, ANDREAS DAAE (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREAS
Middle Name:DAAE
Last Name:STRIDSLAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51538 HIGHWAY 97
Mailing Address - Street 2:STE 2A
Mailing Address - City:LA PINE
Mailing Address - State:OR
Mailing Address - Zip Code:97739-8957
Mailing Address - Country:US
Mailing Address - Phone:541-640-2155
Mailing Address - Fax:
Practice Address - Street 1:51538 HIGHWAY 97
Practice Address - Street 2:STE 2A
Practice Address - City:LA PINE
Practice Address - State:OR
Practice Address - Zip Code:97739-8957
Practice Address - Country:US
Practice Address - Phone:541-640-2155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor