Provider Demographics
NPI:1063622066
Name:HESS, SARA JEANNE (MPT)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:JEANNE
Last Name:HESS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-1870
Mailing Address - Country:US
Mailing Address - Phone:360-736-5273
Mailing Address - Fax:360-996-4466
Practice Address - Street 1:1817 S MARKET BLVD STE C
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-4100
Practice Address - Country:US
Practice Address - Phone:360-996-4410
Practice Address - Fax:360-996-4466
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist