MEDICARE: SARA JANE SACCO

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1326934647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA JANE SACCO

Provider Business Mailing Address
First Line	:	6310 SW VINWOOD TER
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97078-5436
Country	:	US
Telephone Number	:	503-893-0604
Fax Number	:

Provider Business Practice Location Address
First Line	:	13635 NW CORNELL RD STE 160
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-5885
Country	:	US
Telephone Number	:	360-989-7347
Fax Number	:

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

Provider Enumeration Date	:	06/13/2025
Last Update Date	:	06/13/2025

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Directions to “ SARA JANE SACCO ” Practice Location

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