Individual
BRIAN T SUNDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
19856 SE HIGHWAY 212, DAMASCUS, OR 97089-5743
(417) 559-2627
(503) 386-2745
Mailing address
372 SOUTH BROADWAY, ESTACADA, OR 97023
(503) 630-5314
(503) 630-5315
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5367
OR
225100000X
Physical Therapist
PT00008548
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151355
LABOR & INDUSTRIES
WA
01
—
5743SU
REGENCE BLUESHIELD
WA
05
—
8347015
—
WA
01
—
8930584
L&I CRIME VICTIMS PROGRAM
WA
Enumeration date
06/16/2006
Last updated
09/06/2022
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