1346253960 NPI number — KAREN T VALISH L/O.T.R., CHT

Table of content: KAREN T VALISH L/O.T.R., CHT (NPI 1346253960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346253960 NPI number — KAREN T VALISH L/O.T.R., CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VALISH
Provider First Name:
KAREN
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L/O.T.R., CHT
Provider Gender Code:
F

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:
1346253960
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1356
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHEAT RIDGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80034-1356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-237-8899
Provider Business Mailing Address Fax Number:
303-202-1863

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1262 BERGEN PARKWAY
Provider Second Line Business Practice Location Address:
SUITE E18 #4
Provider Business Practice Location Address City Name:
EVERGREEN
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80439-9546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-237-8899
Provider Business Practice Location Address Fax Number:
303-202-1863
Provider Enumeration Date:
08/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  AA386789 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 52225747 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 21148 . This is a "KAISER COMMERCIAL NUMBER" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com