Healthcare Provider Details

I. General information

NPI: 1538059118
Provider Name (Legal Business Name): NORTHWEST HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 FELIX ST
SAINT JOSEPH MO
64501-2706
US

IV. Provider business mailing address

PO BOX 803886
KANSAS CITY MO
64180-3886
US

V. Phone/Fax

Practice location:
  • Phone: 816-232-6818
  • Fax: 816-232-2991
Mailing address:
  • Phone: 816-307-8231
  • Fax: 816-232-2991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MELISSA DUREE
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 816-307-8231