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Contact Information

PACIFIC SPORTS AND INTERVENTIONAL SPINE, LLC-P
123 PONDEROSA DR
SUTHERLIN, OR97479-9812
 Phone: 541-543-2323
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for PACIFIC SPORTS AND INTERVENTIONAL SPINE, LLC-P

NPI # 1215898564
LBN Legal business name PACIFIC SPORTS AND INTERVENTIONAL SPINE, LLC-P
Authorized official KRISTIN BUNCH - (DIRECTOR OF CONTRACTING/CRED)
Entity Organization
Organization subpart 1 No
Enumeration date 11/18/2025
Last updated 11/18/2025 - About 7 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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