Healthcare Provider Details

I. General information

NPI: 1558187716
Provider Name (Legal Business Name): SARAH A UEHARA MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 SW BARNES RD STE 987
PORTLAND OR
97225-6699
US

IV. Provider business mailing address

12002 SW WINDMILL DR APT 12002
BEAVERTON OR
97008-7043
US

V. Phone/Fax

Practice location:
  • Phone: 808-679-7317
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number10234289
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: