Provider Demographics
NPI:1225834930
Name:LUNA, SARA (THW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:LUNA
Suffix:
Gender:
Credentials:THW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6914 N JOHN AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-5320
Mailing Address - Country:US
Mailing Address - Phone:505-659-6299
Mailing Address - Fax:
Practice Address - Street 1:6914 N JOHN AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-5320
Practice Address - Country:US
Practice Address - Phone:505-659-6299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1133338374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula