Provider Demographics
NPI:1902468358
Name:MILLER, SARA (DNP, MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DNP, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NE 8TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-7317
Mailing Address - Country:US
Mailing Address - Phone:503-988-5558
Mailing Address - Fax:503-988-5185
Practice Address - Street 1:600 NE 8TH ST FL 3
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7317
Practice Address - Country:US
Practice Address - Phone:503-988-5558
Practice Address - Fax:503-988-5185
Is Sole Proprietor?:No
Enumeration Date:2019-07-06
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201811245NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily