Provider Demographics
NPI:1114907144
Name:MEYER, SABINE CLARA (MD)
Entity Type:Individual
Prefix:
First Name:SABINE
Middle Name:CLARA
Last Name:MEYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12725 SW MILLIKAN WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1687
Mailing Address - Country:US
Mailing Address - Phone:503-906-7970
Mailing Address - Fax:
Practice Address - Street 1:12725 SW MILLIKAN WAY
Practice Address - Street 2:STE 300
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1687
Practice Address - Country:US
Practice Address - Phone:503-906-7970
Practice Address - Fax:503-334-0886
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD271332084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02196683Medicaid
OR271193Medicaid
NY02196683Medicaid
OR271193Medicaid