Healthcare Provider Details

I. General information

NPI: 1144958786
Provider Name (Legal Business Name): SARA L DURAN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 02/02/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 NW COUNCIL DR STE 200
GRESHAM OR
97030-3723
US

IV. Provider business mailing address

3624 SE 143RD AVE
PORTLAND OR
97236-2726
US

V. Phone/Fax

Practice location:
  • Phone: 503-482-1876
  • Fax:
Mailing address:
  • Phone: 360-909-9979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number64652
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: