Dernbach, Thomas John
Dernbach, Thomas John is an individual health care provider with primary practice located at 2200 Ne Neff Rd Ste 200 , Bend OR 97701-4281. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Dernbach, Thomas John can be contacted via phone (541) 382-3344.Contact Information
Primary practice address
2200 Ne Neff Rd Ste 200
Bend OR 97701-4281
Phone: (541) 382-3344
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA01208 | Oregon |
Profile Details
| NPI number | 1962465211 |
|---|---|
| LBN Legal business name | Dernbach, Thomas John |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2006 |
| Last updated | May 17th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962465211 | NPPES |
| Oregon | MEDICAID | 500616698 |
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