Organization
ACCESS SLEEP MD PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNDREA JACOBS (DIRECTOR)
(503) 384-2135
Entity
Organization
Contact information
Practice address
9900 SW WILSHIRE ST STE 120, PORTLAND, OR 97225-5065
(503) 384-2135
(503) 914-1727
Mailing address
PO BOX 965, LA GRANDE, OR 97850-0965
(503) 384-2135
(503) 914-1727
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0343275
AVAILITY CUSTOMER ID
OR
Enumeration date
07/25/2017
Last updated
03/17/2018
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