Provider Demographics
NPI:1871110502
Name:SANGUINETTI, AMBER (DHSC)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:SANGUINETTI
Suffix:
Gender:F
Credentials:DHSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 NE 48TH AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5020
Mailing Address - Country:US
Mailing Address - Phone:503-681-1848
Mailing Address - Fax:503-681-4348
Practice Address - Street 1:1200 NE 48TH AVE STE 700
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5020
Practice Address - Country:US
Practice Address - Phone:503-681-1848
Practice Address - Fax:503-681-4348
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1275591984Medicaid