Provider Demographics
NPI:1437306628
Name:STANFORD, SARA FRANCES (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:FRANCES
Last Name:STANFORD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:STANFORD
Other - Last Name:HAMBURGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1648
Mailing Address - Country:US
Mailing Address - Phone:541-461-8006
Mailing Address - Fax:541-684-3074
Practice Address - Street 1:4135 QUEST DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-8768
Practice Address - Country:US
Practice Address - Phone:541-461-8006
Practice Address - Fax:541-463-2197
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA10377363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant