MEDICARE: SARAH L. AGSTEN DO, LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1528255866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARAH L. AGSTEN DO, LLC

Provider Business Mailing Address
First Line	:	2508 NW MEDICAL PARK DR
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97471-6220
Country	:	US
Telephone Number	:	541-673-5225
Fax Number	:	541-673-5781

Provider Business Practice Location Address
First Line	:	2508 NW MEDICAL PARK DR
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97471-5510
Country	:	US
Telephone Number	:	541-673-5225
Fax Number	:	541-229-4777

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SARAH LYNN AGSTEN
Credential	:	DO
Telephone Number	:	541-673-5225

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	07/22/2020

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