1295050383 NPI number — JOYE, LLC

Table of content: (NPI 1295050383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295050383 NPI number — JOYE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOYE, 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:
6
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:
1295050383
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8002 NE HIGHWAY 99 # B705
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98665-8876
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-512-2246
Provider Business Mailing Address Fax Number:
877-512-2246

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12812 NE 112TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98682-1652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-512-2246
Provider Business Practice Location Address Fax Number:
877-512-2246
Provider Enumeration Date:
03/31/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MCCORMICK
Authorized Official First Name:
JOYE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
877-512-2246

Provider Taxonomy Codes

  • Taxonomy code: 171R00000X , with the licence number:  602 894 159 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7137508 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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