Provider Demographics
NPI:1326934647
Name:SACCO, SARA JANE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JANE
Last Name:SACCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 SW VINWOOD TER
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97078-5436
Mailing Address - Country:US
Mailing Address - Phone:503-893-0604
Mailing Address - Fax:
Practice Address - Street 1:13635 NW CORNELL RD STE 160
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5885
Practice Address - Country:US
Practice Address - Phone:360-989-7347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist