Healthcare Provider Details

I. General information

NPI: 1285568824
Provider Name (Legal Business Name): PURE HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 VICTORIAN WAY
EUGENE OR
97401-7098
US

IV. Provider business mailing address

1638 VICTORIAN WAY
EUGENE OR
97401-7098
US

V. Phone/Fax

Practice location:
  • Phone: 541-914-6421
  • Fax: 541-914-6421
Mailing address:
  • Phone: 541-914-6421
  • Fax: 541-914-6421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES EDWARD SUITER
Title or Position: CEO / MEDICAL DIRECTOR
Credential: NP
Phone: 541-914-6421