Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 3367 | NV |
Y | 2251N0400X | Physical Therapist - Neurology | 63788 | OR |
NPI | 1215481726 |
---|---|
Provider Name | Sarah Porter |
First Address | Salem, OR 97302-4560 |
Second Address | Salem, OR 97302-4560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2016 |
Last Update Date | 02/07/2021 |