SUNDARA ACUPUNCTURE LLC


Address: 17175 Sw Lisa St, Beaverton, OR 97006-4185
Phone: 5033827179

SUNDARA ACUPUNCTURE LLC (NPI# 1154661163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154661163
Entity Type Organization
Organization Name SUNDARA ACUPUNCTURE LLC
Practice Address 17175 Sw Lisa St
Beaverton
OR 97006-4185
Practice Telephone 5033827179
Mailing Telephone 5033827179
Enumeration Date 2013-02-28
Last Update Date 2013-02-28
Authorized Official Name MR. PHAVIXAY SUNDARA (ACUPUNTURIST)
Authorized Official Telephone 5033827179
Authorized Official Credential LAC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
AC151174 OR Ambulatory Health Care Facilities

Other Data Sources

Entity Type Entity Name Entity Address
Oregon Corporations, Companies and Business Names SUNDARA ACUPUNCTURE LLC 14455 Sw Allen Blvd Suite 101, Beaverton, OR 97005

Office Location

Street Address 17175 SW LISA ST
City BEAVERTON
State OR
Zip Code 97006-4185

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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

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NPI Name Taxonomy Address Enumeration
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NPI Name Taxonomy Address Enumeration
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1356745301 Deschutes Health LLC Clinic/Center 612 Ne Savannah Dr, Suite 1, Bend, OR 97701-4874 2014-10-20
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Competitor

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City BEAVERTON
Zip Code 97006

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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