Healthcare Provider Details

I. General information

NPI: 1326432972
Provider Name (Legal Business Name): SIMPLY HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2015
Last Update Date: 04/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 NW 8TH ST
PENDLETON OR
97801-1332
US

IV. Provider business mailing address

416 NW 8TH ST
PENDLETON OR
97801-1332
US

V. Phone/Fax

Practice location:
  • Phone: 970-389-5570
  • Fax:
Mailing address:
  • Phone: 970-389-5570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number201060057NP
License Number StateOR

VIII. Authorized Official

Name: TRACY ELIZABETH YUN
Title or Position: OWNER
Credential: FNP
Phone: 970-389-5570