Provider Demographics
NPI:1477783215
Name:EKBLAD, SATHER NONE (DC)
Entity Type:Individual
Prefix:DR
First Name:SATHER
Middle Name:NONE
Last Name:EKBLAD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 SW 17TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2572
Mailing Address - Country:US
Mailing Address - Phone:541-504-0250
Mailing Address - Fax:541-504-0252
Practice Address - Street 1:916 SW 17TH ST STE 202
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2572
Practice Address - Country:US
Practice Address - Phone:541-504-0250
Practice Address - Fax:541-504-0252
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor