Healthcare Provider Details

I. General information

NPI: 1134526775
Provider Name (Legal Business Name): NEW FOCUS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2014
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 NW WALL ST SUITE 200
BEND OR
97701-1972
US

IV. Provider business mailing address

1345 NW WALL ST SUITE 200
BEND OR
97701-1972
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-1395
  • Fax: 541-382-6576
Mailing address:
  • Phone: 541-382-1395
  • Fax: 541-382-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN R ELIASON
Title or Position: PRESIDENT
Credential: M D
Phone: 541-382-1395