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General NPI Number Information
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NPI Number | 1770402398
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Entity Type | Organization
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Legal Business Name | SANDRA BIGELOW ENTERPRISES, LLC
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 5441 S MACADAM AVE STE N
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City | PORTLAND
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State | OR
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Zip | 97239-3822
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Country | US
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Telephone | 503-862-8347
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Fax |
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Provider Business Mailing Address
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Address Line | 5331 S MACADAM AVE STE 258
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City | PORTLAND
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State | OR
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Zip | 97239-3871
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Country | US
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Telephone | 503-862-8347
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANDRA BIGELOW
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Credential | OTR/L, REIKI MASTER
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Telephone | 917-442-4749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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