Provider Demographics
NPI:1083178180
Name:NORTHWEST HEALTH PARTNERS NETWORK LLC
Entity Type:Organization
Organization Name:NORTHWEST HEALTH PARTNERS NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-868-9393
Mailing Address - Street 1:3355 RIVERBEND DR STE 430
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-8800
Mailing Address - Country:US
Mailing Address - Phone:541-868-9396
Mailing Address - Fax:
Practice Address - Street 1:3355 RIVERBEND DR STE 430
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8800
Practice Address - Country:US
Practice Address - Phone:541-868-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST HEALTH PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization