Cannon, Sara J
Cannon, Sara J is an individual health care provider with primary practice located at 19260 Sw 65Th Ave Ste 340, Tualatin OR 97062-5701. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Cannon, Sara J can be contacted via phone (503) 691-9777.Contact Information
Primary practice address
19260 Sw 65Th Ave Ste 340
Tualatin OR 97062-5701
Phone: (503) 691-9777
Fax: (503) 692-6736
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD20383 | Oregon |
Profile Details
| NPI number | 1467441477 |
|---|---|
| LBN Legal business name | Cannon, Sara J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2005 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467441477 | NPPES |
| Oregon | MEDICAID | 158870 |
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