# ELYSIAN HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013458405
- **Authorized official:** GABRIELLE FEY (OWNER)
- **Authorized official phone:** (541) 507-4141

## Contact information

- **Practice address:** 835 CRATER LAKE AVE, MEDFORD, OR 97504-6505
- **Practice address phone:** (541) 507-4141
- **Mailing address:** 1630 WILLIAMS HWY, STE 39, GRANTS PASS, OR 97527-5660
- **Mailing address phone:** (541) 507-4141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 201604728NP | OR | Yes |

## Other

- **Enumeration date:** 03/17/2017
- **Last updated:** 03/17/2017