Provider Demographics
NPI:1972566750
Name:VILHAUER, SANDRA A (M D)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:A
Last Name:VILHAUER
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:ARMSTRON
Other - Last Name:VILHAUER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5920 N.E. RAY CIRCLE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6313
Mailing Address - Country:US
Mailing Address - Phone:503-690-0707
Mailing Address - Fax:503-690-9796
Practice Address - Street 1:5920 N. E. RAY CIRCLE
Practice Address - Street 2:SUITE 220
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6313
Practice Address - Country:US
Practice Address - Phone:503-690-0707
Practice Address - Fax:503-690-9796
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD07686208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR205385Medicaid
ORC94549Medicare UPIN
OR205385Medicare ID - Type Unspecified
OR205385Medicaid