Provider Demographics
NPI:1043592421
Name:HOAGLAND, SARAH STEWART (MA)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:STEWART
Last Name:HOAGLAND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 NW LOVEJOY ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2859
Mailing Address - Country:US
Mailing Address - Phone:503-577-1019
Mailing Address - Fax:
Practice Address - Street 1:2525 NW LOVEJOY ST
Practice Address - Street 2:SUITE 407
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2859
Practice Address - Country:US
Practice Address - Phone:503-577-1019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2688101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional