Healthcare Provider Details

I. General information

NPI: 1053222935
Provider Name (Legal Business Name): SYDNEY ALSTON
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23635 NE SUNNYCREST RD
NEWBERG OR
97132-6872
US

IV. Provider business mailing address

23635 NE SUNNYCREST RD
NEWBERG OR
97132-6872
US

V. Phone/Fax

Practice location:
  • Phone: 503-550-2126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberBACHELORS
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: