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NPI Code Detail

MEDICARE: WY EAST ENTERPRISES LLC

MEDICARE: WY EAST ENTERPRISES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477762821
Entity Type Code : Organization
Provider Name (Legal Business Name) : WY EAST ENTERPRISES LLC
Provider Business Mailing Address
First Line : 11211 SE 82ND AVE
Second Line : SUITE B-1
City : HAPPY VALLEY
State : OR
Zip : 97086-7624
Country : US
Telephone Number : 503-653-8700
Fax Number : 503-653-8739
Provider Business Practice Location Address
First Line : 11211 SE 82ND AVE
Second Line : SUITE B-1
City : HAPPY VALLEY
State : OR
Zip : 97086-7624
Country : US
Telephone Number : 503-653-8700
Fax Number : 503-653-8739
Authorized Official
Title or Position : CERTIFIED PEDORTHIST
Name : MRS. MAUREEN LYN WIESE
Credential : C. PED
Telephone Number : 503-653-8700
Provider Enumeration Date : 05/22/2007
Last Update Date : 09/26/2024

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Directions to “WY EAST ENTERPRISES LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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