Healthcare Provider Details

I. General information

NPI: 1245792076
Provider Name (Legal Business Name): ASHLEY DOYLE KHEMRAJ LAC, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 NE CEDAR ST
CAMAS WA
98607-2048
US

IV. Provider business mailing address

PO BOX 593
CAMAS WA
98607-0593
US

V. Phone/Fax

Practice location:
  • Phone: 360-830-6222
  • Fax:
Mailing address:
  • Phone: 360-830-6222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number23-00068
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: