Provider Demographics
NPI:1053828079
Name:VALLEY RESPIRATORY AND HOME SUPPLY
Entity Type:Organization
Organization Name:VALLEY RESPIRATORY AND HOME SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MICKELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-941-5191
Mailing Address - Street 1:818 N 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-1703
Mailing Address - Country:US
Mailing Address - Phone:509-895-5415
Mailing Address - Fax:509-834-7414
Practice Address - Street 1:320 STANLEY BLVD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3753
Practice Address - Country:US
Practice Address - Phone:509-941-5191
Practice Address - Fax:509-834-7414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICKELSON CONSULTING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-29
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies