Provider Demographics
NPI:1053135764
Name:RIVAS, DANIA (NBC-HWC)
Entity type:Individual
Prefix:
First Name:DANIA
Middle Name:
Last Name:RIVAS
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 SW EDGEFIELD MEADOWS TER
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-5448
Mailing Address - Country:US
Mailing Address - Phone:310-210-7587
Mailing Address - Fax:
Practice Address - Street 1:1367 SW EDGEFIELD MEADOWS TER
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-5448
Practice Address - Country:US
Practice Address - Phone:310-210-7587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-3970536171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach