Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 1033656 | OR |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1033656 | OR |
NPI | 1821325978 |
---|---|
Provider Name | Sarah Elizabeth Foidel |
First Address | Forest Grove, OR 97116 |
Second Address | Forest Grove, OR 97116-1939 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2009 |
Last Update Date | 11/11/2009 |