Provider Demographics
NPI:1467848606
Name:SUN VALLEY INTEGRATIVE HEALTH, PLLC
Entity Type:Organization
Organization Name:SUN VALLEY INTEGRATIVE HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:151486
Authorized Official - Phone:4355030069-503-0069
Mailing Address - Street 1:3632 W TYSON ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-4050
Mailing Address - Country:US
Mailing Address - Phone:435-503-0069
Mailing Address - Fax:
Practice Address - Street 1:3632 W TYSON ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4050
Practice Address - Country:US
Practice Address - Phone:435-503-0069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ151486261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care