Basic Information
| Provider Information | |||||||||
| NPI: | 1386083707 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | INSALL | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | RACHEL | ||||||||
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| Credential: | R.D.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 NW MARSHALL ST | ||||||||
| Address2: | 214 | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972092898 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415310709 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4104 SE 82ND AVE | ||||||||
| Address2: | SUITE 450 | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972662954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8554336825 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2013 | ||||||||
| LastUpdateDate: | 06/19/2013 | ||||||||
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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 | 124Q00000X | H6423 | OR | Y | Dental Providers | Dental Hygienist |
No ID Information.