Provider Demographics
NPI:1689488900
Name:CONINE, SAVANNAH RAE
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:RAE
Last Name:CONINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 NE 91ST AVE APT 237
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7547
Mailing Address - Country:US
Mailing Address - Phone:262-891-7381
Mailing Address - Fax:
Practice Address - Street 1:1090 NE 91ST AVE APT 237
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97006-7547
Practice Address - Country:US
Practice Address - Phone:262-891-7381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program