Provider Demographics
NPI:1992358014
Name:OGRIZOVICH, SARAH (LAC, LMT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:OGRIZOVICH
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 NW VERMONT ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1916
Mailing Address - Country:US
Mailing Address - Phone:971-263-3619
Mailing Address - Fax:
Practice Address - Street 1:325 NW VERMONT ST STE 101
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-1916
Practice Address - Country:US
Practice Address - Phone:971-263-3619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC1854672083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine