Healthcare Provider Details

I. General information

NPI: 1831852995
Provider Name (Legal Business Name): SARA GRACE MILLAN SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA G RHOADES SLP

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 SW BARNES RD STE 261
PORTLAND OR
97225-6784
US

IV. Provider business mailing address

9135 SW BARNES RD STE 261
PORTLAND OR
97225-6784
US

V. Phone/Fax

Practice location:
  • Phone: 503-216-2339
  • Fax:
Mailing address:
  • Phone: 503-216-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17319
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: