Provider Demographics
NPI:1487709291
Name:LEWIS, SASHA (LMP, PTA)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMP, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7561 SILVER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MAPLE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:98266-7705
Mailing Address - Country:US
Mailing Address - Phone:360-389-1783
Mailing Address - Fax:
Practice Address - Street 1:7561 SILVER LAKE RD
Practice Address - Street 2:
Practice Address - City:MAPLE FALLS
Practice Address - State:WA
Practice Address - Zip Code:98266-7705
Practice Address - Country:US
Practice Address - Phone:603-891-7933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160213079225200000X
WA181063225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant