Provider Demographics
NPI:1164025185
Name:URBAN OASIS WELLNESS PLLC
Entity Type:Organization
Organization Name:URBAN OASIS WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENICE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENT-MUSLEH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:312-203-7781
Mailing Address - Street 1:5706 NW EL REY DR
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-9120
Mailing Address - Country:US
Mailing Address - Phone:312-203-7781
Mailing Address - Fax:
Practice Address - Street 1:418 NE 4TH AVE STE 105
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2158
Practice Address - Country:US
Practice Address - Phone:312-203-7781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty