| Organization Name: | REMOTE ALLERGY PROVIDERS P.C. |
| NPI Number: | 1245599174 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK ALLEN PRUITT (PRESIDENT) |
| Mailing Address: | 1890 7th St Umatilla |
| State: | OR US |
| Postal Code: | 978829826 |
| Phone Number: | 5416324050 |
| Fax Number: | |
| NPI Enumeration Date: | 05/12/2012 |
| NPI Last Update Date: | 05/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 200850048NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |