Provider Demographics
NPI:1407697527
Name:CLEMO, SARAH ESTHER
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ESTHER
Last Name:CLEMO
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 1:16056 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LA PINE
Mailing Address - State:OR
Mailing Address - Zip Code:97739-9779
Mailing Address - Country:US
Mailing Address - Phone:541-907-6391
Mailing Address - Fax:
Practice Address - Street 1:908 NE 4TH ST # 100
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4646
Practice Address - Country:US
Practice Address - Phone:541-617-7365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist