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NPI Code Detail

MEDICARE: DR. SIERRA MCKENZIE DAWSON PH.D, ATC

MEDICARE: DR. SIERRA MCKENZIE DAWSON PH.D, ATC
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1447291307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIERRA MCKENZIE DAWSON PH.D, ATC
Provider Business Mailing Address
First Line : 845 MADISON ST
Second Line :
City : EUGENE
State : OR
Zip : 97402-5140
Country : US
Telephone Number : 541-484-7413
Fax Number :
Provider Business Practice Location Address
First Line : 1240 UNIVERSITY OF OREGON
Second Line : DEPARTMENT OF HUMAN PHYSIOLOGY
City : EUGENE
State : OR
Zip : 97403-1205
Country : US
Telephone Number : 541-346-1487
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 02/25/2015

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