Healthcare Provider Details

I. General information

NPI: 1366320145
Provider Name (Legal Business Name): SARAH RODRIGUEZ-KAMMERZELT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH RODRIGUEZ RN

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2147 NE VILLAGE CT
MCMINNVILLE OR
97128-9388
US

IV. Provider business mailing address

2147 NE VILLAGE CT
MCMINNVILLE OR
97128-9388
US

V. Phone/Fax

Practice location:
  • Phone: 925-381-3702
  • Fax:
Mailing address:
  • Phone: 925-381-3702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201808772RN
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number201808772RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: