Sarah E Fuller, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

LC-LC-10190129 Issued in OR

Practice address

8910 SE Harrison St
Portland, OR 97216-1939

Phone

(971) 235-8905

NPI assigned

Oct 13, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539388800000",
    "number": "1124593454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8910 SE HARRISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972161939",
            "telephone_number": "971-235-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8910 SE HARRISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972161939",
            "telephone_number": "971-235-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SARAH",
        "middle_name": "E",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-13",
        "last_updated": "2018-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "OR",
            "license": "LC-LC-10190129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Daniel Fuller, LMT
• Kimberly Kay Fuller
• Lanisha Denise Fuller, MD
• Rachel Fuller
• Sara Fuller, LMHCA, LPC INTERN
• Shauna Fuller
• Skylar Fuller
• Kathleen Fullerton, MSED
• Voneda Jane Fullerton, AA
• Ryan Austin Fullmer

• Lactation Consultant (Non-RN) in Portland, OR
• Providers in Portland, OR by specialty
• Lactation Consultant (Non-RN) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.