SUNNYSIDE COLLABORATIVE CARE NPI 1528488996

NPI Information

NPI: 1528488996
Provider Name: SUNNYSIDE COLLABORATIVE CARE
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 38D2104664

Address:
16144 SE HAPPY VALLEY TOWN CENTER DR
SUITE 214
HAPPY VALLEY, OR
ZIP 97086
Phone: (503) 658-7715
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SUNNYSIDE COLLABORATIVE CARE is a health service clinic center in Happy Valley, OR. SUNNYSIDE COLLABORATIVE CARE NPI is 1528488996. The provider is registered as an organization entity type.

The provider's business location address is:

16144 SE HAPPY VALLEY TOWN CENTER DR
SUITE 214
HAPPY VALLEY, OR
ZIP 97086-257
Phone: (503) 658-7715
Fax: (503) 658-7181

The provider's authorized official is Satya Ambrose .
The authorized official title is Owner and has the following contact phone number (503) 658-7715.

The CLIA number assigned to this NPI record is 38D2104664 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/23/2014 and was last updated on 4/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	100484898	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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