Provider Demographics
NPI:1619575388
Name:THOMAS, SIERRA N (PERSONAL CARE ATTEND)
Entity Type:Individual
Prefix:MISS
First Name:SIERRA
Middle Name:N
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PERSONAL CARE ATTEND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 NW HAYES AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4581
Mailing Address - Country:US
Mailing Address - Phone:541-228-9676
Mailing Address - Fax:541-833-6657
Practice Address - Street 1:3827 PINE ST SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-6161
Practice Address - Country:US
Practice Address - Phone:541-730-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider