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General NPI Number Information
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NPI Number | 1750846986
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Entity Type | Individual
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Provider Name | SARA RAY MSN, RN, OCN
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Gender | Female
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 2880 NW STEWART PKWY STE 300
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City | ROSEBURG
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State | OR
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Zip | 97471-1205
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Country | US
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Telephone | 541-229-4070
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Fax |
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Provider Business Mailing Address
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Address Line | 4149 MELQUA RD
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City | ROSEBURG
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State | OR
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Zip | 97471-8955
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Country | US
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Telephone | 541-643-5458
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Fax |
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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 | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | 201141797RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201900884NP-PP
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License Number State | OR
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