Provider Demographics
NPI:1235278839
Name:NATIVE VISIONS INC.
Entity Type:Organization
Organization Name:NATIVE VISIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-265-2063
Mailing Address - Street 1:3643 E LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-1450
Mailing Address - Country:US
Mailing Address - Phone:602-265-2063
Mailing Address - Fax:
Practice Address - Street 1:3643 E LAUREL LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-1450
Practice Address - Country:US
Practice Address - Phone:602-265-2063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies