Healthcare Provider Details

I. General information

NPI: 1295050383
Provider Name (Legal Business Name): JOYE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 04/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12812 NE 112TH ST
VANCOUVER WA
98682-1652
US

IV. Provider business mailing address

8002 NE HIGHWAY 99 # B705
VANCOUVER WA
98665-8876
US

V. Phone/Fax

Practice location:
  • Phone: 877-512-2246
  • Fax: 877-512-2246
Mailing address:
  • Phone: 877-512-2246
  • Fax: 877-512-2246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number602 894 159
License Number StateWA

VIII. Authorized Official

Name: JOYE MCCORMICK
Title or Position: PRESIDENT
Credential:
Phone: 877-512-2246