Provider Demographics
NPI:1548048341
Name:PREHN, SAMMUS KUIPER ROMEO (CRM)
Entity type:Individual
Prefix:
First Name:SAMMUS
Middle Name:KUIPER ROMEO
Last Name:PREHN
Suffix:
Gender:M
Credentials:CRM
Other - Prefix:
Other - First Name:SAMMUS
Other - Middle Name:KUIPER ROMEO
Other - Last Name:ANEY PREHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRM
Mailing Address - Street 1:1027 E BURNSIDE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1027 E BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1328
Practice Address - Country:US
Practice Address - Phone:971-202-7769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist