Active NPI
Sudaisar Polygraph & Forensic Assessments, LLC
- Prevention Professional
- Sherwood, OR
National Provider Identifier
1790460038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- Legal business name
- SUDAISAR POLYGRAPH & FORENSIC ASSESSMENTS, LLC
- Doing business as
- SPFA, LLC
- Practice address
- 22350 SW Pine St
Sherwood, OR 97140-9075 - Phone
- (503) 349-5828
- NPI assigned
- Jun 15, 2023
- Organization subpart
- Yes
- Parent organization
- SUDAISAR POLYGRAPH & FORENSIC ASSESSMENTS, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Scott Desi Sudaisar
- Title
- Owner / Operator
- Phone
- (503) 349-5828
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | Primary |
Addresses
Primary practice location
22350 SW Pine St
Sherwood, OR 97140-9075
Mailing address
PO Box 1238
Newberg, OR 97132-8238
Phone (503) 349-5828
Other practice location 1
62910 O B Riley Rd Ste 310-B
Bend, OR 97703-8697
Phone (503) 349-5828
Other names 1
- SPFA, LLC
National Provider Directory
National Provider Directory- Part of
- Sudaisar Polygraph Forensic Assessments LLC
Locations
62910 Riley Rd
Ste 310B
Bend, OR 97703
Phone (503) 349-5828
22350 SW Pine St
Sherwood, OR 97140
Phone (503) 349-5828
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686787200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1686787200000",
"number": "1790460038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1238",
"city": "NEWBERG",
"state": "OR",
"postal_code": "971328238",
"telephone_number": "503-349-5828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22350 SW PINE ST",
"city": "SHERWOOD",
"state": "OR",
"postal_code": "971409075",
"telephone_number": "503-349-5828"
}
],
"practiceLocations": [
{
"address_1": "62910 O B Riley Rd Ste 310-B",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "977038697",
"country_code": "US",
"telephone_number": "503-349-5828",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SUDAISAR POLYGRAPH & FORENSIC ASSESSMENTS, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUDAISAR POLYGRAPH & FORENSIC ASSESSMENTS, LLC",
"enumeration_date": "2023-06-15",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A",
"authorized_official_last_name": "SUDAISAR",
"authorized_official_first_name": "SCOTT",
"authorized_official_middle_name": "DESI",
"authorized_official_title_or_position": "OWNER / OPERATOR",
"authorized_official_telephone_number": "503-349-5828"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Prevention Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SPFA, LLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sherwood, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.