=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083543391
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PURE HEALTH SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2026
-----------------------------------------------------
Last Update Date | 05/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26895 SW MCLEOD ST
-----------------------------------------------------
City | WILSONVILLE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97070-6815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-454-6472
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26895 SW MCLEOD ST
-----------------------------------------------------
City | WILSONVILLE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97070-6815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-454-6472
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER /OWNER
-----------------------------------------------------
Name | PATRICK LEE EVANGELISTA
-----------------------------------------------------
Credential | EVANGELISTA
-----------------------------------------------------
Telephone | 503-454-6472
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------