Healthcare Provider Details

I. General information

NPI: 1932433885
Provider Name (Legal Business Name): TONYA'S HOUSE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 09/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 SW COURT AVE
PENDLETON OR
97801-2110
US

IV. Provider business mailing address

328 SW COURT AVE
PENDLETON OR
97801-2110
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-2900
  • Fax: 541-429-4410
Mailing address:
  • Phone: 541-276-2900
  • Fax: 541-429-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: SONDRA JEAN KERBY
Title or Position: DIRECTOR
Credential:
Phone: 541-276-2900