Provider Demographics
NPI:1831874064
Name:KNOWLTON, SABRINA ISABEL JUANITA RAMOS
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:ISABEL JUANITA RAMOS
Last Name:KNOWLTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:ISABEL JUANITA
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15220 NW LAIDLAW RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-7717
Mailing Address - Country:US
Mailing Address - Phone:503-418-2000
Mailing Address - Fax:503-418-2400
Practice Address - Street 1:15220 NW LAIDLAW RD STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-7717
Practice Address - Country:US
Practice Address - Phone:503-418-2000
Practice Address - Fax:503-418-2400
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORTHW000109757175T00000X
OR109757172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No175T00000XOther Service ProvidersPeer Specialist