Sky Valley Psychedelic Medical

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SKY VALLEY PSYCHEDELIC MEDICAL

Practice address

101 E Main St Ste 209
Monroe, WA 98272-1519

Phone

(360) 949-7555

NPI assigned

Dec 19, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Palmer LovejoyNPI 1255441689

Title

Physician

Phone

(360) 949-7555

Specialties & licenses 2

Addresses

Other names 1

• Sky Valley Psychedelic Medical Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Palmer Lovejoy, D.O.

  • General Practice Physician
  • Sacramento, CA
  • NPI 1255441689
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671753600000",
    "number": "1689386807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40016 145TH PL SE",
            "city": "GOLD BAR",
            "state": "WA",
            "postal_code": "982519471",
            "telephone_number": "707-239-6190",
            "fax_number": "707-239-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST STE 209",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721519",
            "telephone_number": "360-949-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY VALLEY PSYCHEDELIC MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A",
        "authorized_official_last_name": "LOVEJOY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PALMER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "360-949-7555"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sky Valley Psychedelic Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sky Valley Psychedelic Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sitara Medical Inc PS
• Heidi Colette Sitton, RN
• Skinenvy LLC
• Anne Cathryn Skoog, LMP LICENSED MASSAGE
• Sky Valley Chiropractic Clinic P.S.
• Sky Valley Wellness, LLC
• Dawn Elizabeth Slack, LMT
• Chrystal Slatter, CERTIFIED PEER COUNS
• Gary O Smith, RPH
• Kristin Tomblin Smith, LMP

• Health Service Clinic/Center in Monroe, WA
• Providers in Monroe, WA by specialty
• Health Service Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.