Provider Demographics
NPI:1912338393
Name:CHUNG, ASHLEY PATRICIA (ND)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PATRICIA
Last Name:CHUNG
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 E BROADWAY RD
Mailing Address - Street 2:APT 2001
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1773
Mailing Address - Country:US
Mailing Address - Phone:516-840-8066
Mailing Address - Fax:
Practice Address - Street 1:13660 N 94TH DR
Practice Address - Street 2:STE. C-4
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4836
Practice Address - Country:US
Practice Address - Phone:623-266-1722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13-1406175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath