Youngworth, Sandra J

Youngworth, Sandra J is an individual health care provider with primary practice located at 3303 Sw Bond Ave Ste 7 , Portland OR 97239-4501. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Youngworth, Sandra J can be contacted via phone (503) 494-6594.

Contact Information

Primary practice address
3303 Sw Bond Ave Ste 7 Portland OR 97239-4501
Phone: (503) 494-6594
Fax: (503) 494-5385
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP30007006 Washington
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X H156296 Iowa
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 200550058NP Oregon

Profile Details

NPI number 1114910122
LBN Legal business name Youngworth, Sandra J
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Jan 28th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114910122 NPPES
Washington Other P01543023 RR MEDICARE PTAN
Washington Other P01628718 RR MEDICARE PTAN

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