Provider Demographics
NPI:1770183063
Name:PRAXIS HEALTH, PC
Entity Type:Organization
Organization Name:PRAXIS HEALTH, PC
Other - Org Name:PRAXIS MEDICAL GROUP INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:REAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-966-6136
Mailing Address - Street 1:PO BOX 1517
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0410
Mailing Address - Country:US
Mailing Address - Phone:877-708-1119
Mailing Address - Fax:541-278-8349
Practice Address - Street 1:1890 7TH ST.
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:OR
Practice Address - Zip Code:97882
Practice Address - Country:US
Practice Address - Phone:541-567-6434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRAXIS HEALTH, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-27
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health