Individual
SANDRA LEE EMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1003 PROVIDENCE DR, STE 340, NEWBERG, OR 97132-7485
(503) 538-2698
(503) 554-9328
Mailing address
7650 SW BEVELAND RD, SUITE 200, PORTLAND, OR 97223-8692
(503) 855-1620
(503) 840-3299
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD14746
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
216028
—
OR
01
—
R157974
MEDICARE PTAN
OR
Enumeration date
07/31/2006
Last updated
06/15/2016
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