MEDICARE: SARAH SPOFFORTH MED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-14-16077	OR

General Provider Information

NPI Number	:	1255684973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH SPOFFORTH MED

Provider Business Mailing Address
First Line	:	12200 SE MCLOUGHLIN BLVD APT 5102
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-7240
Country	:	US
Telephone Number	:	925-570-1747
Fax Number	:

Provider Business Practice Location Address
First Line	:	12200 SE MCLOUGHLIN BLVD APT 5102
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-7240
Country	:	US
Telephone Number	:	925-570-1747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	02/02/2026

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Directions to “ SARAH SPOFFORTH MED” Practice Location

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