Provider Demographics
NPI:1164625778
Name:SPEAR, SARAH (BSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SPEAR
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21163 SW DANA CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6516
Mailing Address - Country:US
Mailing Address - Phone:503-593-9398
Mailing Address - Fax:
Practice Address - Street 1:3431 SE 36TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1817
Practice Address - Country:US
Practice Address - Phone:503-863-5901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8494877101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor