Organization Name: | HALE HEALTH, LLC |
NPI Number: | 1134558976 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CONSTANCE ERICKSON (CO-OWNER) |
Mailing Address: | 18813 Sw Martinazzi Ave Tualatin |
State: | OR US |
Postal Code: | 970626807 |
Phone Number: | 5037655265 |
Fax Number: | 5037655265 |
NPI Enumeration Date: | 11/02/2013 |
NPI Last Update Date: | 12/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 1976 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |