Individual
SARA STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
19250 SW 65TH AVE STE 300, TUALATIN, OR 97062-7707
(503) 692-1242
(503) 691-3615
Mailing address
7650 SW BEVELAND RD STE 200, PORTLAND, OR 97223-8692
(503) 601-3615
(503) 646-1683
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201243065RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201801794NP-PP
OR
Other
Enumeration date
09/23/2013
Last updated
02/08/2019
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