Provider Demographics
NPI:1932790896
Name:NELSON, SARAH CAITLIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:CAITLIN
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:CAITLIN
Other - Last Name:MORRISON-COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1311 SE 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-2648
Mailing Address - Country:US
Mailing Address - Phone:503-433-3443
Mailing Address - Fax:
Practice Address - Street 1:3439 SE HAWTHORNE BLVD # 1114
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-5048
Practice Address - Country:US
Practice Address - Phone:503-433-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3336103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist