Provider Demographics
NPI:1598595795
Name:HAAG, SARA COLEEN
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:COLEEN
Last Name:HAAG
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 1:50 KERR PKWY APT 68
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8835
Mailing Address - Country:US
Mailing Address - Phone:503-488-0033
Mailing Address - Fax:
Practice Address - Street 1:50 KERR PKWY APT 68
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8835
Practice Address - Country:US
Practice Address - Phone:503-488-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty