Provider Demographics
NPI:1790502847
Name:PIERRE, CHAD URI
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:URI
Last Name:PIERRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11551 SW 30TH ST UNIT 302
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7849
Mailing Address - Country:US
Mailing Address - Phone:561-386-5344
Mailing Address - Fax:
Practice Address - Street 1:425 2ND AVE SW STE 201
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2260
Practice Address - Country:US
Practice Address - Phone:916-249-3271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33067174H00000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator