Provider Demographics
NPI:1598130965
Name:SARAH MCDONNELL LLC
Entity Type:Organization
Organization Name:SARAH MCDONNELL LLC
Other - Org Name:PLAY WORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MCDONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:716-866-0756
Mailing Address - Street 1:512 CASCADE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-2126
Mailing Address - Country:US
Mailing Address - Phone:541-716-1316
Mailing Address - Fax:
Practice Address - Street 1:512 CASCADE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2126
Practice Address - Country:US
Practice Address - Phone:541-716-1316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR015665261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation