Healthcare Provider Details

I. General information

NPI: 1326074840
Provider Name (Legal Business Name): SANDI LAZETTE FIELDS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 OAK ST SE STE C3010
SALEM OR
97301-3975
US

IV. Provider business mailing address

875 OAK ST SE STE 3010
SALEM OR
97301-3978
US

V. Phone/Fax

Practice location:
  • Phone: 503-399-7520
  • Fax: 503-362-7344
Mailing address:
  • Phone: 503-561-4090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number9501324
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number61021236
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD204289
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9501324
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: