Organization
SPA SASSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA SASSE LMT (MANAGING MEMBER)
(808) 283-6669
Entity
Organization
Contact information
Practice address
630 SW ALDER ST, PORTLAND, OR 97205-3616
(503) 228-8266
Mailing address
PO BOX 22266, PORTLAND, OR 97269-2266
(503) 228-8266
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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