Provider Demographics
NPI:1649164104
Name:GALL, SARAH MAE (SLP CLINICAL FELLOW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MAE
Last Name:GALL
Suffix:
Gender:F
Credentials:SLP CLINICAL FELLOW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74324 E COLD SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ZIGZAG
Mailing Address - State:OR
Mailing Address - Zip Code:97049-8787
Mailing Address - Country:US
Mailing Address - Phone:541-280-8380
Mailing Address - Fax:
Practice Address - Street 1:2085 INLAND DR STE A
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-1203
Practice Address - Country:US
Practice Address - Phone:541-267-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist