Provider Demographics
NPI:1265248058
Name:SUNBEAM CENTER
Entity type:Organization
Organization Name:SUNBEAM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATHENAEL HAILEGIORG
Authorized Official - Middle Name:
Authorized Official - Last Name:HAILEGIORGIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-255-2773
Mailing Address - Street 1:330 1ST ST APT 479
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3293
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:330 1ST ST APT 479
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3293
Practice Address - Country:US
Practice Address - Phone:971-255-2773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center