1942978036 NPI number — LITZY EMILIA LOEZA RAMIREZ BS, QMHA

Table of content: LITZY EMILIA LOEZA RAMIREZ BS, QMHA (NPI 1942978036)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942978036 NPI number — LITZY EMILIA LOEZA RAMIREZ BS, QMHA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOEZA RAMIREZ
Provider First Name:
LITZY
Provider Middle Name:
EMILIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BS, QMHA
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:
1942978036
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10920 SW WILSONVILLE RD APT 25
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILSONVILLE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97070-8514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14127 SW 114TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIGARD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97224-3709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-747-4338
Provider Business Practice Location Address Fax Number:
503-747-4387
Provider Enumeration Date:
09/02/2021

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: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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