Provider Demographics
NPI:1356013205
Name:MADDUX, SARAH CHRISTINE (RN)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:CHRISTINE
Last Name:MADDUX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-8772
Mailing Address - Country:US
Mailing Address - Phone:541-386-2688
Mailing Address - Fax:833-857-4733
Practice Address - Street 1:729 HENDERSON RD
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-8772
Practice Address - Country:US
Practice Address - Phone:541-386-2688
Practice Address - Fax:833-857-4733
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202005448RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR202005448RNMedicaid