Provider Demographics
NPI:1912642380
Name:LEGRAND, SARAH E (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:LEGRAND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 SW 21ST ST APT 304
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-4477
Mailing Address - Country:US
Mailing Address - Phone:317-650-3237
Mailing Address - Fax:
Practice Address - Street 1:707 SW 37TH ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3605
Practice Address - Country:US
Practice Address - Phone:541-276-3374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-01
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR64185225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist