Provider Demographics
NPI:1578816088
Name:PERRY, DENNIS ALAN (ND)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ALAN
Last Name:PERRY
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 WILCOMBE DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA
Mailing Address - State:CA
Mailing Address - Zip Code:93428-5246
Mailing Address - Country:US
Mailing Address - Phone:503-327-6642
Mailing Address - Fax:888-233-5452
Practice Address - Street 1:2320 WILCOMBE DR
Practice Address - Street 2:
Practice Address - City:CAMBRIA
Practice Address - State:CA
Practice Address - Zip Code:93428
Practice Address - Country:US
Practice Address - Phone:503-327-6642
Practice Address - Fax:888-233-5452
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1927175F00000X
CANDF1080175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500655563Medicaid