Provider Demographics
NPI:1558876284
Name:VANISH PAIN & ALLERGY
Entity Type:Organization
Organization Name:VANISH PAIN & ALLERGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:602-576-6770
Mailing Address - Street 1:6807 W CARTER RD
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-7051
Mailing Address - Country:US
Mailing Address - Phone:602-576-6770
Mailing Address - Fax:602-535-4859
Practice Address - Street 1:207 W CLARENDON AVE STE 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3447
Practice Address - Country:US
Practice Address - Phone:602-576-6770
Practice Address - Fax:602-535-4859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service