Provider Demographics
NPI:1225505506
Name:SIMELES, VY PHAM (ND)
Entity Type:Individual
Prefix:
First Name:VY
Middle Name:PHAM
Last Name:SIMELES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:PHAM
Other - Last Name:SIMELES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16144 SE HAPPY VALLEY TOWN CENTER DR STE 214
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-4257
Mailing Address - Country:US
Mailing Address - Phone:503-658-7715
Mailing Address - Fax:503-658-7181
Practice Address - Street 1:16144 SE HAPPY VALLEY TOWN CENTER DR STE 214
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-4257
Practice Address - Country:US
Practice Address - Phone:503-658-7715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
OR4194175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath