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1306740949 NPI number — VA

NPI Number: 1306740949
Health Care Provider/Practitioner: VA

Information about “1306740949” NPI (VA) exists in 1306740949 in HTML format HTML  |  1306740949 in plain Text format TXT  |  1306740949 in PDF (Portable Document Format) PDF  |  1306740949 in an XML format XML  formats.

NPI Number : 1306740949 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306740949",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "VA",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "587 TEAKWOOD DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EAGLE POINT",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97524-9494",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "541-778-0526",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8495 CRATER LAKE HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WHITE CITY",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97503-3011",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "541-826-2111",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/06/2026",
    "LastUpdateDate": "10/06/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SNELL",
    "AuthorizedOfficialFirstName": "MAHABBAT",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "VOCATIONAL REHAB. COUNSELOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LPMHC",
    "AuthorizedOfficialTelephoneNumber": "541-826-2111",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225C00000X",
        "TaxonomyName": "Rehabilitation Counselor",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "NULL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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