1619575388 NPI number — MISS SIERRA N THOMAS PERSONAL CARE ATTEND

Table of content: MISS SIERRA N THOMAS PERSONAL CARE ATTEND (NPI 1619575388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619575388 NPI number — MISS SIERRA N THOMAS PERSONAL CARE ATTEND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMAS
Provider First Name:
SIERRA
Provider Middle Name:
N
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
PERSONAL CARE ATTEND
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:
1619575388
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
961 NW HAYES AVE APT 24
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORVALLIS
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97330-4581
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-228-9676
Provider Business Mailing Address Fax Number:
541-833-6657

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3827 PINE ST SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97322-6161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-730-2603
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2020

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: 3747A0650X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com