Provider Demographics
NPI:1477988822
Name:SMITH, SARAH MICHAEL (APRN, CNP, PNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHAEL
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN, CNP, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 PENN LN
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1592
Mailing Address - Country:US
Mailing Address - Phone:503-655-7725
Mailing Address - Fax:
Practice Address - Street 1:1713 PENN LN
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1592
Practice Address - Country:US
Practice Address - Phone:503-655-7725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK96507363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics