Provider Demographics
NPI:1003094756
Name:REESE, SARAH (LAC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2336
Mailing Address - Street 2:
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672-2336
Mailing Address - Country:US
Mailing Address - Phone:509-637-3307
Mailing Address - Fax:509-637-2776
Practice Address - Street 1:145 E. JEWETT BLVD
Practice Address - Street 2:301
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672
Practice Address - Country:US
Practice Address - Phone:509-637-3307
Practice Address - Fax:509-637-2776
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002993171100000X
ORAC01061171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist