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General NPI Number Information
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NPI Number | 1528255866
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Entity Type | Organization
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Legal Business Name | SARAH L. AGSTEN DO, LLC
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 2508 NW MEDICAL PARK DR
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City | ROSEBURG
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State | OR
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Zip | 97471-5510
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Country | US
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Telephone | 541-673-5225
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Fax | 541-229-4777
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Provider Business Mailing Address
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Address Line | 2508 NW MEDICAL PARK DR
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City | ROSEBURG
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State | OR
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Zip | 97471-6220
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Country | US
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Telephone | 541-673-5225
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Fax | 541-673-5781
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SARAH LYNN AGSTEN
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Credential | DO
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Telephone | 541-673-5225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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