Sara Drage

Individual provider Active NPI Speech-Language Pathologist · Seaside, OR

NPI 1205248697 · NPPES record last updated May 20, 2014

Key facts

NPI
1205248697
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
014063 (OR)
Practice address
725 S Wahanna Rd
Seaside, OR 97138-7735
Phone
(503) 717-7789
NPI assigned
May 20, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
014063ORMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 014063 OR Yes

Addresses

Primary practice location

725 S Wahanna Rd
Seaside, OR 97138-7735

Mailing address

261 Railroad Ave
Gearhart, OR 97138-4402
Phone (503) 791-4258

Other providers in Seaside, OR

All providers in Seaside, OR · Speech-Language Pathologist in Oregon

Sources for this page

Verify at the official NPI Registry.