Provider Demographics
NPI:1760598163
Name:OLIVER, SARARUTH ANN (AUD)
Entity Type:Individual
Prefix:DR
First Name:SARARUTH
Middle Name:ANN
Last Name:OLIVER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2065
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:OR
Mailing Address - Zip Code:97024-1813
Mailing Address - Country:US
Mailing Address - Phone:503-220-8262
Mailing Address - Fax:503-721-7979
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY (P2AUD)
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:503-721-7979
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20906231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist