Sally Hafez Kordab, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD229975 Issued in OR

Practice address

4855 SW Western Ave
Beaverton, OR 97005-3460

Phone

(800) 813-2000

NPI assigned

Apr 6, 2022

Last updated

Sep 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascension Seton

  dba Ascension Seton Medical Center Austin

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1164526786
  NPD (past)

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1710628292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322099",
            "telephone_number": "800-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 SW WESTERN AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053460",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDAB",
        "first_name": "SALLY",
        "middle_name": "HAFEZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD.MD.701260",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD229975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Kokoszka
• Kian Kolahi
• Melanie Kong-Shaw, M.A., B.C.B.A
• Sandhya V Koppula, MD
• Kor Bodywork and Wellness LLC
• Tanya Kornuta, RDH
• Anna Koroteyev, RDH
• Andrea Noel Koskamp, DPT
• Shahana Koslofsky, PHD
• Candace Marie Kostianis

• Pediatrics Physician in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.