Healthcare Provider Details

I. General information

NPI: 1164000972
Provider Name (Legal Business Name): SETH ALLEN ALFORD ARNP FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

YELLOWHAWK TRIBAL HEALTH CENTER 46314 TIMINE WAY
PENDLETON OR
97801
US

IV. Provider business mailing address

YELLOWHAWK TRIBAL HEALTH CENTER 46314 TIMINE WAY
PENDLETON OR
97801
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-9830
  • Fax:
Mailing address:
  • Phone: 541-966-9830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61138182
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: