Provider Demographics
NPI:1811356991
Name:ADAM, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ADAM
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 1:1200 NE 48TH AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-4904
Mailing Address - Country:US
Mailing Address - Phone:503-640-6064
Mailing Address - Fax:
Practice Address - Street 1:1200 NE 48TH AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-4904
Practice Address - Country:US
Practice Address - Phone:503-640-6064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist