Provider Demographics
NPI:1548978315
Name:WINSTON FROJEN, SARA GABRIELA (MA, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:SARA
Middle Name:GABRIELA
Last Name:WINSTON FROJEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3705 SE MONROE ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-5947
Mailing Address - Country:US
Mailing Address - Phone:971-356-4546
Mailing Address - Fax:
Practice Address - Street 1:10330 SE 32ND AVE STE 105
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6596
Practice Address - Country:US
Practice Address - Phone:503-513-8600
Practice Address - Fax:503-513-8196
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR015306235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist