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NPI Code Detail

MEDICARE: SARAH REBECCA PAUL PMHNP

MEDICARE: SARAH REBECCA PAUL PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner201394040NP-PPOR

General Provider Information

NPI Number : 1366872517
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH REBECCA PAUL PMHNP
Provider Business Mailing Address
First Line : 7084 SW 181ST PL
Second Line :
City : ALOHA
State : OR
Zip : 97007-5252
Country : US
Telephone Number : 503-781-3278
Fax Number :
Provider Business Practice Location Address
First Line : 10300 SW EASTRIDGE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97225-5004
Country : US
Telephone Number : 503-944-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2013
Last Update Date : 01/20/2017

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