Healthcare Provider Details

I. General information

NPI: 1184560344
Provider Name (Legal Business Name): SARAH MUSKA
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N DIXON ST
PORTLAND OR
97227-1876
US

IV. Provider business mailing address

501 N DIXON ST
PORTLAND OR
97227-1876
US

V. Phone/Fax

Practice location:
  • Phone: 503-916-2000
  • Fax:
Mailing address:
  • Phone: 503-916-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number553283
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: