Healthcare Provider Details

I. General information

NPI: 1598697294
Provider Name (Legal Business Name): SARA ROCIO STRUIKSMA ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 NW 2ND AVE
CANBY OR
97013-3729
US

IV. Provider business mailing address

PO BOX 853
MULINO OR
97042-0853
US

V. Phone/Fax

Practice location:
  • Phone: 503-266-2997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number5134
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: