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Contact Information

CACHE VALLEY EAR NOSE & THROAT, PLLC
2245 N 400 E
STE 301
NORTH LOGAN, UT84341-1892
 Phone: 435-753-7880
 Fax: 435-359-4507
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for CACHE VALLEY EAR NOSE THROAT PLLC · (Female)

NPI # 1548303795
Status Active
Credentials
Entity Individual
Enumeration date 02/15/2007
Last updated 06/24/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • UT License # C97276
  • ID Medicaid 805387100
  • UT Medicaid 1548303795
  • UT Medicaid 87037196400
  • WY Medicaid 118280300
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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