Healthcare Provider Details

I. General information

NPI: 1780509588
Provider Name (Legal Business Name): SABRINA F JONES-WYATT BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6675 SW NYBERG LN APT 121
TUALATIN OR
97062-7807
US

IV. Provider business mailing address

6675 SW NYBERG LN APT 121
TUALATIN OR
97062-7807
US

V. Phone/Fax

Practice location:
  • Phone: 269-816-4115
  • Fax:
Mailing address:
  • Phone: 269-816-4115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704308854
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.RN.61507590
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201909693RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: