Individual provider Active NPI

Laura Baker Sander, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1407139397
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L6866 Issued in OR
Practice address
4675 NW Owyhee CT
Portland, OR 97229-2731
Phone
(971) 533-8112
NPI assigned
Sep 27, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X L6866 OR Primary

Addresses

Primary practice location

4675 NW Owyhee CT
Portland, OR 97229-2731

Mailing address

4675 NW Owyhee CT
Portland, OR 97229-2731
Phone (971) 533-8112

Other practice location 1

8196 SW Hall Blvd
#202
Beaverton, OR 97008-6409
Phone (971) 533-8112

Other names 1

  • Laura Baker Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L6866ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1407139397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4675 NW OWYHEE CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972292731",
            "telephone_number": "971-533-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4675 NW OWYHEE CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972292731",
            "telephone_number": "971-533-8112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8196 SW Hall Blvd",
            "address_2": "#202",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970086409",
            "country_code": "US",
            "telephone_number": "971-533-8112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDER",
        "first_name": "LAURA",
        "middle_name": "BAKER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BAKER",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.