Provider Demographics
NPI:1043056500
Name:COLUMBIA SEXUAL ASSAULT RESPONSE NETWORK (C-SARN)
Entity type:Organization
Organization Name:COLUMBIA SEXUAL ASSAULT RESPONSE NETWORK (C-SARN)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:REARDON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:503-307-6834
Mailing Address - Street 1:PO BOX 1088
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051-8088
Mailing Address - Country:US
Mailing Address - Phone:503-307-6834
Mailing Address - Fax:
Practice Address - Street 1:1621 COLUMBIA BLVD
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-6221
Practice Address - Country:US
Practice Address - Phone:971-757-0865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health