Provider Demographics
NPI:1962054767
Name:KLEINE, SARAH (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KLEINE
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8923 SE ALDER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-1609
Mailing Address - Country:US
Mailing Address - Phone:971-284-7471
Mailing Address - Fax:
Practice Address - Street 1:1650 SE 3RD AVE STE 209
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2093
Practice Address - Country:US
Practice Address - Phone:971-284-7471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
OR016543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist