Individual
SARA HARKNESS BOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 PROVIDENCE DR, NEWBERG, OR 97132-7485
(503) 537-5607
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00046687
WA
207R00000X
Internal Medicine Physician
MD162389
OR
208M00000X
Hospitalist Physician
Primary
MD162389
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500661794
—
OR
05
—
8468662
—
WA
01
—
G000362000
MEDICARE GROUP
WA
01
—
P00395878
RR MEDICARE ID
WA
Enumeration date
08/22/2006
Last updated
03/30/2017
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