Sprague, Amy M
Sprague, Amy M is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Sprague, Amy M can be contacted via phone (503) 494-1164.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd
Portland OR 97239-3011
Phone: (503) 494-1164
Fax: (503) 494-5502
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD195005 | Oregon |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | M15250 | Idaho |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | MD195005 | Oregon |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 035145 | Georgia |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 15949 | South Carolina |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD195005 | Oregon |
Profile Details
| NPI number | 1629030598 |
|---|---|
| LBN Legal business name | Sprague, Amy M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Jun 17th, 2024 - about last year |
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 | 1629030598 | NPPES |
| South Carolina | Other | 15949 | SC LICENSE # |
| South Carolina | Other | 035145 | SC LICENSE # |
| South Carolina | MEDICAID | 000506701I | SC LICENSE # |
| South Carolina | MEDICAID | G35145 | SC LICENSE # |
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