1275662322 NPI number — ARETE SLEEP THERAPY NW LLC

Table of content: (NPI 1275662322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275662322 NPI number — ARETE SLEEP THERAPY NW LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARETE SLEEP THERAPY NW LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275662322
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 840414
Provider Second Line Business Mailing Address:
SUITE 395
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-0414
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-282-6531
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2460 NE GRIFFIN OAKS ST
Provider Second Line Business Practice Location Address:
SUITE D-1000
Provider Business Practice Location Address City Name:
HILLSBORO
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97124-2672
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-352-0700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BAUMANN
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
480-282-6532

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 500603976 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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