Provider Demographics
NPI:1720861040
Name:MTOS HEALTH LLC
Entity Type:Organization
Organization Name:MTOS HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEMITAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAGBEMI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:971-553-8186
Mailing Address - Street 1:13203 SE 172ND AVE
Mailing Address - Street 2:STE 166, PMB1082
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3785 RIVER RD N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-5098
Practice Address - Country:US
Practice Address - Phone:971-553-8186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty