Individual
SADIE LYN ROUSSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7238 N BURLINGTON AVE, PORTLAND, OR 97203-4817
(971) 238-1946
Mailing address
5224 NE 43RD AVE, PORTLAND, OR 97218-1514
(971) 238-1946
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
BAP-FA-10257024
OR
Other
Enumeration date
01/31/2026
Last updated
01/31/2026
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