Provider Demographics
NPI:1972316917
Name:SORENSEN, DON J III (PA)
Entity type:Individual
Prefix:MR
First Name:DON
Middle Name:J
Last Name:SORENSEN
Suffix:III
Gender:M
Credentials:PA
Other - Prefix:MR
Other - First Name:DJ
Other - Middle Name:
Other - Last Name:SORENSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:76 E NORTH TOWNE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84054-2507
Mailing Address - Country:US
Mailing Address - Phone:360-640-8597
Mailing Address - Fax:
Practice Address - Street 1:76 E NORTH TOWNE LN
Practice Address - Street 2:
Practice Address - City:NORTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84054-2507
Practice Address - Country:US
Practice Address - Phone:360-640-8597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program