Pacific Sage LLC
Clinic/Center in Bend, OR. Organization (NPI-2).
NPI number1609697218
StatusActive
Last updated in NPPESOct 17, 2024
Details
- NPI
- 1609697218
- Entity type
- Organization (NPI-2)
- Legal business name
- Pacific Sage LLC
- Organization subpart
- No
- Enumeration date
- Oct 17, 2024
- Certification date
- Oct 17, 2024
- Last updated
- Oct 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Other names
- Pacific Sage Primary Care (Doing Business As)
Practice location
527 Ne Bellevue Dr Ste 200Bend, OR 97701-8744
Phone 541-640-7243 · Fax 541-645-7243
Mailing address
2660 Ne Highway 20Suite 610 #524
Bend, OR 97701
Phone 541-762-2727 · Fax 541-645-7243
Other practice locations
2041 Ne Williamson Ct Ste B
Bend, OR 97701-3941
Bend, OR 97701-3941
Phone 541-640-7243 · Fax 541-645-7243
Authorized official
Ann Ottesen
NP, Owner
5417622727
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