Individual provider Active NPI

Skylar Douglas, LE

  • Other Specialist/Technologist
  • Bend, OR
National Provider Identifier
1376481192
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
License
BAP-E-10266881 Issued in OR
Practice address
2669 NE Twin Knolls Dr # 110
Bend, OR 97701-4895
Phone
(541) 241-7412
NPI assigned
Mar 23, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246Z00000X BAP-E-10266881 OR Primary

Addresses

Primary practice location

2669 NE Twin Knolls Dr # 110
Bend, OR 97701-4895

Mailing address

2669 NE Twin Knolls Dr # 110
Bend, OR 97701-4895
Phone (541) 241-7412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BAP-E-10266881ORMDOther Specialist/Technologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1376481192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2669 NE TWIN KNOLLS DR # 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014895",
            "telephone_number": "541-241-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 NE TWIN KNOLLS DR # 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014895",
            "telephone_number": "541-241-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SKYLAR",
        "credential": "LE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": "OR",
            "license": "BAP-E-10266881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.