MEDICARE: SARA WOOD, ND 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	261QM1300X	Multi-Specialty Clinic/Center	1551	OR

General Provider Information

NPI Number	:	1962799353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARA WOOD, ND LLC

Provider Business Mailing Address
First Line	:	5310 SW ERICKSON AVE
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97005-3849
Country	:	US
Telephone Number	:	503-515-8183
Fax Number	:	503-643-1024

Provider Business Practice Location Address
First Line	:	4085 SW 109TH AVE
Second Line	:	SUITE 200
City	:	BEAVERTON
State	:	OR
Zip	:	97005-3000
Country	:	US
Telephone Number	:	503-643-1024
Fax Number	:	503-644-1293

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SARA GRACE WOOD
Credential	:	ND
Telephone Number	:	503-515-8183

Provider Enumeration Date	:	07/06/2011
Last Update Date	:	07/06/2011

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Directions to “SARA WOOD, ND LLC ” Practice Location

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