Healthcare Provider Details

I. General information

NPI: 1831211598
Provider Name (Legal Business Name): SAGE HEALTH CENTER, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 NE EMERSON AVE SUITE 101
BEND OR
97701-4900
US

IV. Provider business mailing address

1900 NE 3RD ST SUITE 106-346
BEND OR
97701-3854
US

V. Phone/Fax

Practice location:
  • Phone: 541-385-6249
  • Fax: 541-383-4152
Mailing address:
  • Phone: 541-385-6249
  • Fax: 541-383-4152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number751
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00201
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. SHEILA MARGUERITA MYERS
Title or Position: OWNER AND OPERATOR
Credential: N.D., L.AC.
Phone: 541-385-6249