Provider Demographics
NPI:1699223933
Name:JONES, SARA E (PT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:JONES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:463 TREMONT ST W STE 100
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3743
Mailing Address - Country:US
Mailing Address - Phone:360-874-0745
Mailing Address - Fax:360-874-0846
Practice Address - Street 1:463 TREMONT ST W STE 100
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3743
Practice Address - Country:US
Practice Address - Phone:360-874-0745
Practice Address - Fax:360-874-0846
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61219477225100000X
TX1279091225100000X
CA2966602251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX456752Medicare PIN