Provider Demographics
NPI:1275972416
Name:SOMMERVILLE, SARAH (MA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:SOMMERVILLE
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17692 SW BALLARD LN
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-7865
Mailing Address - Country:US
Mailing Address - Phone:503-515-8241
Mailing Address - Fax:
Practice Address - Street 1:17692 SW BALLARD LN
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-7865
Practice Address - Country:US
Practice Address - Phone:503-515-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health