Provider Demographics
NPI:1609413145
Name:MCSTRAVOG, SARAH ELIZABETH (MSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:MCSTRAVOG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 SE DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1138
Mailing Address - Country:US
Mailing Address - Phone:619-922-8714
Mailing Address - Fax:
Practice Address - Street 1:308 SW 1ST AVE STE 155
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-3432
Practice Address - Country:US
Practice Address - Phone:503-808-1256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker