Basic Information
| Provider Information | |||||||||
| NPI: | 1316266307 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HADLEY | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | COTA | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 650 SE OAK ST | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971234120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036488588 | ||||||||
| FaxNumber: | 5036488589 | ||||||||
| Practice Location | |||||||||
| Address1: | 650 SE OAK ST | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971234120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036488588 | ||||||||
| FaxNumber: | 5036488589 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2010 | ||||||||
| LastUpdateDate: | 05/31/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 1052596 | OR | Y | Other Service Providers | Specialist |
No ID Information.