Healthcare Provider Details

I. General information

NPI: 1073852281
Provider Name (Legal Business Name): DAISY C.H.A.I.N. CREATING HEALTHY ALLIANCES IN NEW-MOTHERING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 OAK ST
EUGENE OR
97401-4022
US

IV. Provider business mailing address

PO BOX 10375
EUGENE OR
97440-2375
US

V. Phone/Fax

Practice location:
  • Phone: 541-505-1139
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: JACLYN MAHONEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 541-505-1139