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General NPI Number Information
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NPI Number | 1841173523
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Entity Type | Individual
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Provider Name | SARAH R WILSON PHD, MA, APC
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Gender | Female
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 5441 S MACADAM AVE STE R
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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 | 503-573-5681
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Fax |
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Provider Business Mailing Address
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Address Line | SOUL WEAVING COUNSELING, LLC 5331 S MACADAM AVE, SUITE 258; PMB 420
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City | PORTLAND
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State | OR
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Zip | 97239
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Country | US
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Telephone | 503-573-5681
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | R11134
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License Number State | OR
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