Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 57.008910 | OH |
N | 207V00000X | Obstetrician & Gynecologist | MD2011-0047 | NM |
N | 207V00000X | Obstetrician & Gynecologist | MD28406 | OR |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD28406 | OR |
NPI | 1912199134 |
---|---|
Provider Name | Sara Cichowski |
First Address | Portland, OR 97239-3011 |
Second Address | Portland, OR 97239-3011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2007 |
Last Update Date | 05/06/2020 |