Healthcare Provider Details

I. General information

NPI: 1043592421
Provider Name (Legal Business Name): SARAH STEWART HOAGLAND M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 NW LOVEJOY ST SUITE 407
PORTLAND OR
97210-2859
US

IV. Provider business mailing address

2525 NW LOVEJOY ST SUITE 407
PORTLAND OR
97210-2859
US

V. Phone/Fax

Practice location:
  • Phone: 503-577-1019
  • Fax:
Mailing address:
  • Phone: 503-577-1019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC2688
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: