Provider Demographics
NPI:1669083259
Name:WORT, SARAH LOUISE
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LOUISE
Last Name:WORT
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 1:7257 PARK TERRACE DR NE
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-1796
Mailing Address - Country:US
Mailing Address - Phone:503-559-7061
Mailing Address - Fax:
Practice Address - Street 1:2111 FRONT ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0765
Practice Address - Country:US
Practice Address - Phone:503-559-7061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula