MEDICARE: SARAH JANE WRIGHT RDN, IBCLC

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
1	174N00000X	Lactation Consultant (Non-RN)	L-84672	OR
2	133V00000X	Registered Dietitian	DI61465536	WA

General Provider Information

NPI Number	:	1477906089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH JANE WRIGHT RDN, IBCLC

Provider Business Mailing Address
First Line	:	3059 SE 119TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97266-1615
Country	:	US
Telephone Number	:	503-686-9838
Fax Number	:

Provider Business Practice Location Address
First Line	:	1516 W RIVERSIDE AVE STE 205
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-1241
Country	:	US
Telephone Number	:	509-557-7150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2016
Last Update Date	:	01/11/2024

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