Sandee D Penter
Individual provider Active NPI Contractor · Toledo, OR
NPI 1508006115 · NPPES record last updated Feb 23, 2009
Key facts
- NPI
- 1508006115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 805 NE Reservoir LN
Toledo, OR 97391-1335 - Phone
- (541) 336-2254
- Fax
- (541) 336-1803
- NPI assigned
- Feb 23, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
805 NE Reservoir LN
Toledo, OR 97391-1335
Mailing address
805 NE Reservoir LN
Toledo, OR 97391-1335
Phone (541) 336-2254
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93-0698327 | Other | OR | PRIVATE NON PROFIT |
Other providers in Toledo, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.