Organization
PACIFIC SPORTS AND INTERVENTIONAL SPINE, LLC-P
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN BUNCH (DIRECTOR OF CONTRACTING/CRED)
(503) 953-0357
Entity
Organization
Contact information
Practice address
123 PONDEROSA DR, SUTHERLIN, OR 97479-9812
(541) 543-2323
Mailing address
123 PONDEROSA DR, SUTHERLIN, OR 97479-9812
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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