Provider Demographics
NPI:1285618546
Name:THOMPSON, SARAH JOHANNA (LMP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JOHANNA
Last Name:THOMPSON
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 1:17104 NE 45TH ST
Mailing Address - Street 2:#4
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5630
Mailing Address - Country:US
Mailing Address - Phone:425-241-2341
Mailing Address - Fax:
Practice Address - Street 1:12015 NE 8TH ST
Practice Address - Street 2:STE 1
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3141
Practice Address - Country:US
Practice Address - Phone:425-635-0544
Practice Address - Fax:425-450-0365
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021502225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist