Basic Information
| Provider Information | |||||||||
| NPI: | 1104029768 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SARFF | ||||||||
| FirstName: | MARYCLARE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3181 SW SAM JACKSON PARK RD | ||||||||
| Address2: | DEPT. OF SURGERY L223 | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972393011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034947758 | ||||||||
| FaxNumber: | 5034945615 | ||||||||
| Practice Location | |||||||||
| Address1: | 2275 NE DOCTORS DR STE 6 | ||||||||
| Address2: | |||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977016092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417066915 | ||||||||
| FaxNumber: | 5417066733 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2007 | ||||||||
| LastUpdateDate: | 04/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | LL16462 | OR | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.