Individual
SARAH TANAKA GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1955 NW NORTHRUP ST, PORTLAND, OR 97209-1614
(503) 227-2020
(503) 222-0614
Mailing address
1955 NW NORTHRUP ST, PORTLAND, OR 97209-1614
(503) 227-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD204309
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500794226
—
OR
01
—
R227666
MEDICARE
OR
Enumeration date
03/24/2017
Last updated
09/09/2021
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