Provider Demographics
NPI:1386921468
Name:FAIRCHILD, SARAH ANNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANNE
Last Name:FAIRCHILD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11825 SW GREENBURG RD STE 203
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6466
Mailing Address - Country:US
Mailing Address - Phone:503-395-7289
Mailing Address - Fax:
Practice Address - Street 1:11825 SW GREENBURG RD STE 203
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6466
Practice Address - Country:US
Practice Address - Phone:503-395-7289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2167103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist