Healthcare Provider Details

I. General information

NPI: 1124689823
Provider Name (Legal Business Name): ARK MANAGEMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 NE WYNOOSKI RD STE A2
NEWBERG OR
97132-7196
US

IV. Provider business mailing address

3201 NE WYNOOSKI RD STE A2
NEWBERG OR
97132-7196
US

V. Phone/Fax

Practice location:
  • Phone: 971-224-9181
  • Fax: 503-214-8353
Mailing address:
  • Phone: 971-224-9181
  • Fax: 503-214-8353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: KERI MERIE JULIAN
Title or Position: OWNER
Credential:
Phone: 971-224-9181