Provider Demographics
NPI:1154793255
Name:PIRIE, SAHARA (LMP)
Entity type:Individual
Prefix:
First Name:SAHARA
Middle Name:
Last Name:PIRIE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16026 WALLINGFORD AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-5832
Mailing Address - Country:US
Mailing Address - Phone:206-546-4142
Mailing Address - Fax:
Practice Address - Street 1:16026 WALLINGFORD AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-5832
Practice Address - Country:US
Practice Address - Phone:206-546-4142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00004872172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA65661OtherWA STATE LABOR & INDUSTRIES