Provider Demographics
NPI:1407190663
Name:BENRATH, SARAH LEOLA (MPH, MSN, PNP-BC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LEOLA
Last Name:BENRATH
Suffix:
Gender:F
Credentials:MPH, MSN, PNP-BC
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 4228
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-4228
Mailing Address - Country:US
Mailing Address - Phone:413-833-0055
Mailing Address - Fax:541-383-1883
Practice Address - Street 1:230 NE 6TH ST RM S-19
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-5103
Practice Address - Country:US
Practice Address - Phone:541-383-3005
Practice Address - Fax:541-383-1883
Is Sole Proprietor?:No
Enumeration Date:2012-11-11
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR202011070NP-PP364SP0200X, 364SP0200X
NY382329363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics