Sandberg, Derri
Sandberg, Derri is an individual health care provider with primary practice located at 901 Nw Carlon Ave Ste 2 , Bend OR 97703-2636. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Sandberg, Derri can be contacted via phone (541) 382-3242.Contact Information
Primary practice address
901 Nw Carlon Ave Ste 2
Bend OR 97703-2636
Phone: (541) 382-3242
Fax: (541) 317-3579
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3213ATI | Oregon |
Profile Details
| NPI number | 1831397306 |
|---|---|
| LBN Legal business name | Sandberg, Derri |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2007 |
| Last updated | Jul 14th, 2015 - about 9 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 | 1831397306 | NPPES |
| Oregon | MEDICAID | 243164 |
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