Provider Demographics
NPI:1063026987
Name:LINDAUER, SARA MARIE (PT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:LINDAUER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 SE QUAIL CIR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-5147
Mailing Address - Country:US
Mailing Address - Phone:805-807-3467
Mailing Address - Fax:
Practice Address - Street 1:3934 NE MARTIN LUTHER KING JR BLVD STE 203
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-1153
Practice Address - Country:US
Practice Address - Phone:503-223-1856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist