Healthcare Provider Details

I. General information

NPI: 1467219543
Provider Name (Legal Business Name): JOSEPH RYAN PLOUFF PARAMEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 04/21/2024
Certification Date: 04/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68098 N BAY RD
NORTH BEND OR
97459-8521
US

IV. Provider business mailing address

68098 N BAY RD
NORTH BEND OR
97459-8521
US

V. Phone/Fax

Practice location:
  • Phone: 620-518-3456
  • Fax:
Mailing address:
  • Phone: 620-518-3456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: