Healthcare Provider Details

I. General information

NPI: 1851888614
Provider Name (Legal Business Name): AUDREY SACHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19075 NW TANASBOURNE DR STE 300
HILLSBORO OR
97124-5802
US

IV. Provider business mailing address

2323 NW 188TH AVE APT 725
HILLSBORO OR
97124-7088
US

V. Phone/Fax

Practice location:
  • Phone: 503-531-1709
  • Fax:
Mailing address:
  • Phone: 541-510-3084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: