Sunbreak Therapy Services, Inc

Organization Active NPI Speech-Language Pathologist · Canby, OR

NPI 1497150247 · NPPES record last updated Jul 25, 2023

Key facts

NPI
1497150247
Entity type
Organization (NPI type 2)
Primary specialty
Speech-Language Pathologist 235Z00000X
Legal business name
SUNBREAK THERAPY SERVICES, INC
Practice address
366 N. Holly St.
Canby, OR 97013
Phone
(503) 266-1030
Fax
(971) 244-9044
NPI assigned
Oct 22, 2014
Organization subpart
No

Authorized official

Name
Sarah E Burgon
Title
Owner
Phone
(503) 266-1030

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230719002773 OR Part B Supplier - Clinic/Group Practice 3870953045 Receives reassigned benefits from 3 practitioners
Practice locations: Beaverton, OR; Canby, OR; Portland, OR

National Provider Directory

Locations

8700 SW Creekside Pl
Ste B
Beaverton, OR 97008
Phone (503) 224-2184

366 N Holly St
Canby, OR 97013
Phone (503) 266-1030

181 N Grant St
Ste 207A
Canby, OR 97013

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X
Speech-Language Pathologist
Group: 193400000X SINGLE SPECIALTY GROUP
235Z00000X 013412 OR
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X Yes

Addresses

Primary practice location

366 N. Holly St.
Canby, OR 97013

Mailing address

PO Box 946
Canby, OR 97013
Phone (503) 266-1030

Other practice location 1

6516 NE Siskiyou St
Portland, OR 97213-4572
Phone (503) 266-1030

Other identifiers

IdentifierTypeStateIssuer
500658826MedicaidOR
1518369123OtherORNPI
1740832732OtherORNPI
1962540153OtherORNPI

Other names

  • Speech With Sarah, LLC Former legal business name
  • Speech With Sarah - LLC Other name

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL info@sunbreakclinic.com Direct

Other providers in Canby, OR

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

Sources for this page

Verify at the official NPI Registry.