Individual
SARA HAASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
333 S STATE ST, LAKE OSWEGO, OR 97034-3932
(971) 533-2521
Mailing address
3905 SE 54TH AVE, #1, PORTLAND, OR 97206-3982
(971) 533-2521
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
21020
OR
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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