Provider Demographics
NPI:1801204607
Name:WILLIAMS, SARAH (RDH)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34018 SLAVENS RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OR
Mailing Address - Zip Code:97053-9518
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:32972 NW RIDGE DR
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-6200
Practice Address - Country:US
Practice Address - Phone:503-369-2619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6779124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist