Individual
SARA EMMA WOHLGEMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
3727 NE MLK JR BLVD, PORTLAND, OR 97212-1112
(503) 788-7273
(503) 788-7286
Mailing address
PO BOX 2927, PORTLAND, OR 97208-2927
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201706156NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201706156NP-PP
STATE LICENSE
OR
Enumeration date
08/21/2017
Last updated
08/21/2017
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