Provider Demographics
NPI:1215628144
Name:GREENBERG, SARAH MICHELLE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MICHELLE
Last Name:GREENBERG
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:610 HIGH ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2241
Practice Address - Country:US
Practice Address - Phone:503-657-8903
Practice Address - Fax:503-266-8632
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OR485216225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No101Y00000XBehavioral Health & Social Service ProvidersCounselor