Provider Demographics
NPI:1639718893
Name:ALLEN, SARAH LOUISE (MFA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 491
Mailing Address - Street 2:
Mailing Address - City:NEOTSU
Mailing Address - State:OR
Mailing Address - Zip Code:97364-0491
Mailing Address - Country:US
Mailing Address - Phone:541-557-1892
Mailing Address - Fax:
Practice Address - Street 1:412 SE HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-2772
Practice Address - Country:US
Practice Address - Phone:541-557-1892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No172V00000XOther Service ProvidersCommunity Health Worker