Provider Demographics
NPI:1174987309
Name:SIRONA DX INC.
Entity type:Organization
Organization Name:SIRONA DX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NASRY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:YASSA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:503-442-3580
Mailing Address - Street 1:16869 65TH AVE STE 163
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-7865
Mailing Address - Country:US
Mailing Address - Phone:503-430-8778
Mailing Address - Fax:
Practice Address - Street 1:14401 SE 1ST ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-3503
Practice Address - Country:US
Practice Address - Phone:503-442-3580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA50D2111263291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory