Provider Demographics
NPI:1316264369
Name:MORRISON, SARA D (LMP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:D
Last Name:MORRISON
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 1:4907 N NORMANDIE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-5117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:621 W MALLON AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2163
Practice Address - Country:US
Practice Address - Phone:509-443-4293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023301225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist