Provider Demographics
NPI:1538670591
Name:VALDEZ MOBILE PHLEBOTOMY LLC
Entity Type:Organization
Organization Name:VALDEZ MOBILE PHLEBOTOMY LLC
Other - Org Name:VALDEZ MOBILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:971-240-0995
Mailing Address - Street 1:41385 FISH HATCHERY DR
Mailing Address - Street 2:
Mailing Address - City:SCIO
Mailing Address - State:OR
Mailing Address - Zip Code:97374-9745
Mailing Address - Country:US
Mailing Address - Phone:971-240-0995
Mailing Address - Fax:503-296-2629
Practice Address - Street 1:41385 FISH HATCHERY DR
Practice Address - Street 2:
Practice Address - City:SCIO
Practice Address - State:OR
Practice Address - Zip Code:97374-9745
Practice Address - Country:US
Practice Address - Phone:971-240-0995
Practice Address - Fax:503-296-2629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health