Provider Demographics
NPI:1427473347
Name:CHASE, SARAH (L AC, LMT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:L AC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 NE 78TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-6338
Mailing Address - Country:US
Mailing Address - Phone:828-216-7326
Mailing Address - Fax:
Practice Address - Street 1:3327 SE HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-5046
Practice Address - Country:US
Practice Address - Phone:828-216-7326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR164079171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist