Individual
DR. BEAU JEFFREY SOBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 706-5811
(541) 706-5867
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
(206) 520-3186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD197614
OR
207R00000X
Internal Medicine Physician
MD60579470
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073856324
—
WA
01
—
8952369
MEDICARE PIN
WA
Enumeration date
04/04/2013
Last updated
09/16/2021
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