Provider Demographics
NPI:1437248358
Name:ASKARI, SANAZ W (DO)
Entity Type:Individual
Prefix:DR
First Name:SANAZ
Middle Name:W
Last Name:ASKARI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 NW WYATT CT STE 101
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7679
Mailing Address - Country:US
Mailing Address - Phone:541-318-0124
Mailing Address - Fax:541-318-0188
Practice Address - Street 1:2115 NE WYATT CT STE 101
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7679
Practice Address - Country:US
Practice Address - Phone:541-318-0124
Practice Address - Fax:541-318-0188
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO26360174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR005697Medicaid
OR133575Medicare ID - Type Unspecified
OR005697Medicare UPIN
ORH98921Medicare UPIN