Provider Demographics
NPI:1528788361
Name:RICHARD, DENA CHRISTINE
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:CHRISTINE
Last Name:RICHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENA
Other - Middle Name:CHRISTINE
Other - Last Name:VAAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1860 REES HILL RD SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-2860
Mailing Address - Country:US
Mailing Address - Phone:971-706-0353
Mailing Address - Fax:
Practice Address - Street 1:445 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2272
Practice Address - Country:US
Practice Address - Phone:541-967-3866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program