Provider Demographics
NPI:1609123090
Name:JANE, SARAH (RN, BSN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:JANE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:FURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:704 NE 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-4310
Mailing Address - Country:US
Mailing Address - Phone:503-481-6807
Mailing Address - Fax:
Practice Address - Street 1:2073 OLYMPIC ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-3413
Practice Address - Country:US
Practice Address - Phone:541-682-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201142636RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse