Organization
SANDARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA LARE DO (OWNER)
(503) 708-2165
Entity
Organization
Contact information
Practice address
690 SW STEPHENSON ST, PORTLAND, OR 97219-7899
(503) 708-2165
Mailing address
690 SW STEPHENSON ST, PORTLAND, OR 97219-7899
(503) 708-2165
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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