Individual
SARA LAUREN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
665 MARINO DR N, KEIZER, OR 97303-5842
(503) 616-1105
Mailing address
665 MARINO DR N, KEIZER, OR 97303-5842
(503) 616-1105
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-10224717
OR
2255A2300X
Athletic Trainer
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Other
Enumeration date
07/21/2022
Last updated
07/21/2022
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