Healthcare Provider Details

I. General information

NPI: 1205715901
Provider Name (Legal Business Name): AZURE THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 SE DORION AVE
PENDLETON OR
97801-2529
US

IV. Provider business mailing address

802 NW BAILEY AVE
PENDLETON OR
97801-1531
US

V. Phone/Fax

Practice location:
  • Phone: 541-304-3177
  • Fax: 541-203-3967
Mailing address:
  • Phone: 541-304-3177
  • Fax: 541-203-3967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KRISTI SMITH KRISTI SMITH
Title or Position: ADMIN
Credential:
Phone: 509-308-0276