Provider Demographics
NPI:1750846986
Name:RAY, SARA (MSN, RN, OCN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:MSN, RN, OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4149 MELQUA RD
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-8955
Mailing Address - Country:US
Mailing Address - Phone:541-643-5458
Mailing Address - Fax:
Practice Address - Street 1:2880 NW STEWART PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1205
Practice Address - Country:US
Practice Address - Phone:541-229-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201141797RN163WX0200X
OR201900884NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology