Provider Demographics
NPI:1235679606
Name:BAIN, SARAH TERESE (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:TERESE
Last Name:BAIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:TERESE
Other - Last Name:KJOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:6575 SW 207TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97078-4142
Mailing Address - Country:US
Mailing Address - Phone:503-327-6414
Mailing Address - Fax:
Practice Address - Street 1:6575 SW 207TH AVE
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97078-4142
Practice Address - Country:US
Practice Address - Phone:503-327-6414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor