Provider Demographics
NPI:1417135427
Name:TAYLOR, SARAH HATHAWAY (LDEM)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:HATHAWAY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 NE BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1816
Mailing Address - Country:US
Mailing Address - Phone:503-805-4680
Mailing Address - Fax:
Practice Address - Street 1:3351 NE BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1816
Practice Address - Country:US
Practice Address - Phone:503-805-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR176B00000X176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife