Provider Demographics
NPI:1871764936
Name:PINNACLE SLEEP OF OREGON LLC
Entity type:Organization
Organization Name:PINNACLE SLEEP OF OREGON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABHIJIT
Authorized Official - Middle Name:G
Authorized Official - Last Name:DESHPANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-469-1903
Mailing Address - Street 1:1460 N 16TH AVE
Mailing Address - Street 2:STE. B
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7102
Mailing Address - Country:US
Mailing Address - Phone:509-248-0497
Mailing Address - Fax:509-248-4167
Practice Address - Street 1:1050 W ELM AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-2700
Practice Address - Country:US
Practice Address - Phone:509-469-1903
Practice Address - Fax:509-469-1905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR279163Medicaid
OR279163Medicaid
ORR147770Medicare PIN