Healthcare Provider Details

I. General information

NPI: 1477663268
Provider Name (Legal Business Name): ATTILIA MARIE SAWYER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 SW WESTERN AVE
BEAVERTON OR
97005-3460
US

IV. Provider business mailing address

4560 SW HILLSIDE DR
PORTLAND OR
97221-3139
US

V. Phone/Fax

Practice location:
  • Phone: 503-643-7565
  • Fax:
Mailing address:
  • Phone: 503-296-0451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD18394
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD00041145
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: