Provider Demographics
NPI:1598480683
Name:ROSENAU, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ROSENAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 BLANKENSHIP RD STE 448
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4191
Mailing Address - Country:US
Mailing Address - Phone:971-378-0367
Mailing Address - Fax:503-974-9679
Practice Address - Street 1:1800 BLANKENSHIP RD STE 448
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4191
Practice Address - Country:US
Practice Address - Phone:971-378-0367
Practice Address - Fax:503-974-9679
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OR1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical