Provider Demographics
NPI:1023336914
Name:SLEEP MANAGEMENT GROUP, LLC
Entity type:Organization
Organization Name:SLEEP MANAGEMENT GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-517-0607
Mailing Address - Street 1:1917 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7205
Mailing Address - Country:US
Mailing Address - Phone:541-517-0607
Mailing Address - Fax:541-344-6802
Practice Address - Street 1:2310 NW KINGS BLVD
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3925
Practice Address - Country:US
Practice Address - Phone:541-517-0607
Practice Address - Fax:541-344-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory