Provider Demographics
NPI:1477906089
Name:WRIGHT, SARAH JANE (RDN, IBCLC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RDN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3059 SE 119TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-1615
Mailing Address - Country:US
Mailing Address - Phone:503-686-9838
Mailing Address - Fax:
Practice Address - Street 1:1516 W RIVERSIDE AVE STE 205
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1241
Practice Address - Country:US
Practice Address - Phone:509-557-7150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL-84672174N00000X
WADI61465536133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN