Doctor Name: | SARAH JANE DUVAL |
NPI Number: | 1134294507 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PMHNP |
License Number: | 082011172N6 |
Business Practice Address: | 3787 River Road N, Suite A Keizer, OR - 97303 |
Business Phone Number: | 5035818175 |
Business Fax Number: | 5035899274 |
Mailing Address: | Po Box 6141, SALEM |
State: | OR |
Postal Code: | 97304 |
Phone Number: | 5035818175 |
Fax Number: | 5035899274 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 05/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 082011172N6 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |