Sundahl, Brian T

Sundahl, Brian T is an individual health care provider with primary practice located at 19856 Se Highway 212 , Damascus OR 97089-5743. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Sundahl, Brian T can be contacted via phone (417) 559-2627.

Contact Information

Primary practice address
19856 Se Highway 212 Damascus OR 97089-5743
Phone: (417) 559-2627
Fax: (503) 386-2745
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT00008548 Washington
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 5367 Oregon

Profile Details

NPI number 1790729952
LBN Legal business name Sundahl, Brian T
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Sep 6th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790729952 NPPES
Washington Other 5743SU REGENCE BLUESHIELD
Washington Other 151355 REGENCE BLUESHIELD
Washington MEDICAID 8347015 REGENCE BLUESHIELD
Washington Other 8930584 REGENCE BLUESHIELD

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