Provider Demographics
NPI:1992048532
Name:SAPIGAO, NICOLETTE (DPT)
Entity type:Individual
Prefix:MS
First Name:NICOLETTE
Middle Name:
Last Name:SAPIGAO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:NICOLETTE
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 SW INDUSTRIAL WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1093
Mailing Address - Country:US
Mailing Address - Phone:541-504-2350
Mailing Address - Fax:541-504-2354
Practice Address - Street 1:1315 NW 4TH ST APT B
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1328
Practice Address - Country:US
Practice Address - Phone:541-504-2350
Practice Address - Fax:541-504-2354
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38190225100000X
OR63655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist