Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Scott Desi Sudaisar

Individual provider Prevention Professional · NPI 1649955980

Scott Desi Sudaisar is a Prevention Professional in Sherwood, Oregon. Practices as a sole proprietor and works from 2 locations. Licensed in Oregon.

Licensed in
OR
In the registry since
2023

Practice location Address checks out

22350 SW Pine St
Sherwood, OR 97140-9075
Phone: (503) 349-5828
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 62910 O B Riley Rd Ste 301-B, Bend, OR 97703-8697 — (503) 349-5828

Specialties & licences

Prevention Professional (primary) Taxonomy 405300000X · Licence 083697 (OR)

Record details

NPI number1649955980
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 15, 2023
Last updated in NPPESJune 15, 2023
Certification dateJune 15, 2023
Mailing addressPo Box 1238, Newberg, OR 97132-8238

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