Basic Information
| Provider Information | |||||||||
| NPI: | 1942925326 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PRAXIS HEALTH, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1517 | ||||||||
| Address2: | |||||||||
| City: | PENDLETON | ||||||||
| State: | OR | ||||||||
| PostalCode: | 978010410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8777081119 | ||||||||
| FaxNumber: | 5412788349 | ||||||||
| Practice Location | |||||||||
| Address1: | 531 SE CLAY ST | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973382865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9716126100 | ||||||||
| FaxNumber: | 9716126101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2022 | ||||||||
| LastUpdateDate: | 10/07/2022 | ||||||||
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| AuthorizedOfficialLastName: | REAGAN | ||||||||
| AuthorizedOfficialFirstName: | JESSICA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | REVENUE CYCLE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5419666136 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.