Healthcare Provider Details

I. General information

NPI: 1861919037
Provider Name (Legal Business Name): SARAH SCOTT DYRHAUG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 E MADISON ST STE 300
SEATTLE WA
98112
US

IV. Provider business mailing address

11035 NE SANDY BLVD
PORTLAND OR
97220-2553
US

V. Phone/Fax

Practice location:
  • Phone: 971-219-7998
  • Fax:
Mailing address:
  • Phone: 503-258-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: