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General NPI Number Information
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NPI Number | 1619772290
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Entity Type | Organization
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Legal Business Name | SAGE THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 9390 SW IBACH CT
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City | TUALATIN
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State | OR
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Zip | 97062-7073
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Country | US
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Telephone | 971-200-5756
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Fax | 971-203-2048
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Provider Business Mailing Address
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Address Line | 9390 SW IBACH CT
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City | TUALATIN
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State | OR
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Zip | 97062-7073
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Country | US
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Telephone | 971-200-5756
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Fax | 971-203-2048
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | TANUJINI ROSALIND CARLSON
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Credential | M.A.
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Telephone | 971-235-0914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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