Basic Information
Provider Information
NPI: 1144655069
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DASCH
FirstName: ASHLEY
MiddleName: ROSE
NamePrefix: MRS.
NameSuffix:  
Credential: B.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1790 W 11TH AVE
Address2:  
City: EUGENE
State: OR
PostalCode: 974023758
CountryCode: US
TelephoneNumber: 5416862611
FaxNumber:  
Practice Location
Address1: 2517 MLK JR BLVD
Address2:  
City: EUGENE
State: OR
PostalCode: 974015898
CountryCode: US
TelephoneNumber: 5413424293
FaxNumber: 5413424832
Other Information
ProviderEnumerationDate: 09/10/2013
LastUpdateDate: 09/10/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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