Individual
NICHOLAS E SUNDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
220 S PINE ST STE 102, SISTERS, OR 97759-1670
(541) 903-5822
Mailing address
220 S PINE ST STE 102, SISTERS, OR 97759-1670
(541) 903-5822
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4413
OR
Other
Enumeration date
08/14/2012
Last updated
12/29/2023
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