# NICK SUNDSTROM LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033613815
- **Authorized official:** NICHOLAS ERIC SUNDSTROM LCSW (OWNER/PROVIDER)
- **Authorized official phone:** (541) 647-7820

## Contact information

- **Practice address:** 2659 SW 4TH ST STE 110, REDMOND, OR 97756
- **Practice address phone:** (541) 647-7820
- **Mailing address:** 2659 SW 4TH ST STE 110, REDMOND, OR 97756-6406
- **Mailing address phone:** (541) 647-7820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | 4413 | OR | — |
| 261QM0850X | Adult Mental Health Clinic/Center | 4413 | OR | — |

## Other

- **Enumeration date:** 03/19/2018
- **Last updated:** 10/05/2018