Provider Demographics
NPI:1912369430
Name:PLUM VILLAGE WELLNESS
Entity Type:Organization
Organization Name:PLUM VILLAGE WELLNESS
Other - Org Name:NEW HARMONY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSKOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-823-0888
Mailing Address - Street 1:202 E MCLOUGHLIN BLVD
Mailing Address - Street 2:201
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3369
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:202 E MCLOUGHLIN BLVD
Practice Address - Street 2:201
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3369
Practice Address - Country:US
Practice Address - Phone:360-823-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center