MEDICARE: SANDRA DEE BUNN CNS-PP, ACNS-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SA2200X	Adult Health Clinical Nurse Specialist	201390180CNS-PP	OR

General Provider Information

NPI Number	:	1477985737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA DEE BUNN CNS-PP, ACNS-BC

Provider Business Mailing Address
First Line	:	890 OAK ST SE BLDG B
Second Line	:	PO BOX 14001
City	:	SALEM
State	:	OR
Zip	:	97301-3905
Country	:	US
Telephone Number	:	503-561-1543
Fax Number	:	503-561-4719

Provider Business Practice Location Address
First Line	:	4240 SHORELINE DR N
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303-5829
Country	:	US
Telephone Number	:	801-648-3824
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2013
Last Update Date	:	04/14/2026

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