MEDICARE: SARAH LOUISE ALLEN MFA

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1639718893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH LOUISE ALLEN MFA

Provider Business Mailing Address
First Line	:	PO BOX 491
Second Line	:
City	:	NEOTSU
State	:	OR
Zip	:	97364-0491
Country	:	US
Telephone Number	:	541-557-1892
Fax Number	:

Provider Business Practice Location Address
First Line	:	412 SE HIGHWAY 101
Second Line	:
City	:	LINCOLN CITY
State	:	OR
Zip	:	97367-2772
Country	:	US
Telephone Number	:	541-557-1892
Fax Number	:

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

Provider Enumeration Date	:	01/04/2020
Last Update Date	:	09/11/2025

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