Fanning-Painter, Dustin Alexander
Fanning-Painter, Dustin Alexander is an individual health care provider with primary practice located at 1340 Nw Wall St , Bend OR 97703-1985. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Fanning-Painter, Dustin Alexander can be contacted via phone (541) 322-7500.Contact Information
Primary practice address
1340 Nw Wall St
Bend OR 97703-1985
Phone: (541) 322-7500
Fax: (541) 322-7565
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | Oregon |
Profile Details
| NPI number | 1679011274 |
|---|---|
| LBN Legal business name | Fanning-Painter, Dustin Alexander |
| Credentials | QMHA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 3rd, 2017 |
| Last updated | Dec 12th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679011274 | NPPES |
| Oregon | MEDICAID | 171M00000X |
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