Individual
SARAH E FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
8910 SE HARRISON ST, PORTLAND, OR 97216-1939
(971) 235-8905
Mailing address
8910 SE HARRISON ST, PORTLAND, OR 97216-1939
(971) 235-8905
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
LC-LC-10190129
OR
Other
Enumeration date
10/13/2018
Last updated
10/13/2018
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