Individual
DR. DERRI SANDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
901 NW CARLON AVE STE 2, BEND, OR 97703-2636
(541) 382-3242
(541) 317-3579
Mailing address
901 NW CARLON AVE, BEND, OR 97703-2636
(541) 382-3242
(541) 317-3579
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3213ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243164
—
OR
Enumeration date
07/06/2007
Last updated
07/14/2015
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