Provider Demographics
NPI:1780789503
Name:SIRONA LLC
Entity type:Organization
Organization Name:SIRONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SANSUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-368-6711
Mailing Address - Street 1:37315 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NEHALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97131-9634
Mailing Address - Country:US
Mailing Address - Phone:503-368-6711
Mailing Address - Fax:503-368-6712
Practice Address - Street 1:37315 3RD ST
Practice Address - Street 2:
Practice Address - City:NEHALEM
Practice Address - State:OR
Practice Address - Zip Code:97131-9634
Practice Address - Country:US
Practice Address - Phone:503-368-6711
Practice Address - Fax:503-368-6712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR133724Medicare ID - Type Unspecified