BLUE STAR HEALING ARTS PC NPI 1578865275

NPI Information

NPI: 1578865275
Provider Name: BLUE STAR HEALING ARTS, PC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
714 NW 5TH ST
GRANTS PASS, OR
ZIP 97526
Phone: (541) 244-1511
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BLUE STAR HEALING ARTS, PC is a health service clinic center in Grants Pass, OR. BLUE STAR HEALING ARTS, PC NPI is 1578865275. The provider is registered as an organization entity type.

The provider's business location address is:

714 NW 5TH ST
GRANTS PASS, OR
ZIP 97526-529
Phone: (541) 244-1511
Fax: (541) 244-1512

The provider's authorized official is Mona Mynnel Tara .
The authorized official title is Owner and has the following contact phone number (541) 244-2292.

The enumeration date for this NPI number is 12/1/2010 and was last updated on 12/12/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	MD15235	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	E98978	MEDICARE UPIN	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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