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General NPI Number Information
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NPI Number | 1588181184
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Entity Type | Individual
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Provider Name | SARAH RENNALLS
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Gender | Female
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 08/24/2017
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Provider Practice Location Address
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Address Line | 16315 SW BARROWS ROAD #203
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City | BEAVERTON
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State | OR
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Zip | 97007
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Country | US
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Telephone | 503-746-6583
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Fax |
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Provider Business Mailing Address
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Address Line | 3280 SW 170TH AVE APT 2716
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City | BEAVERTON
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State | OR
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Zip | 97003-8618
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Country | US
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Telephone | 503-893-2947
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Fax | 503-893-2947
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 023472
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License Number State | OR
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