Provider Demographics
NPI:1124531512
Name:SUNSHINE CONCEPTS LLC
Entity type:Organization
Organization Name:SUNSHINE CONCEPTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:CELESTE
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:541-430-5393
Mailing Address - Street 1:PO BOX 923
Mailing Address - Street 2:
Mailing Address - City:SUTHERLIN
Mailing Address - State:OR
Mailing Address - Zip Code:97479-0923
Mailing Address - Country:US
Mailing Address - Phone:541-430-7410
Mailing Address - Fax:
Practice Address - Street 1:100 EAST CENTRAL AVE.
Practice Address - Street 2:10 SOUTH STATE ST. BACK OF BLDG
Practice Address - City:SUTHERLIN
Practice Address - State:OR
Practice Address - Zip Code:97479-9556
Practice Address - Country:US
Practice Address - Phone:541-459-7410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00490171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1245407980OtherNPPES