Provider Demographics
NPI:1801364724
Name:LAMKIN, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:LAMKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4874 SE ROCKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-5018
Mailing Address - Country:US
Mailing Address - Phone:971-506-7309
Mailing Address - Fax:
Practice Address - Street 1:4874 SE ROCKWOOD ST
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-5018
Practice Address - Country:US
Practice Address - Phone:971-506-7309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201804615RN163WR0400X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation