Provider Demographics
NPI:1003097445
Name:EMORY, SARAH LEE (LMT, CAR)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LEE
Last Name:EMORY
Suffix:
Gender:F
Credentials:LMT, CAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 DIBBLE AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3243
Mailing Address - Country:US
Mailing Address - Phone:206-781-9656
Mailing Address - Fax:206-706-7058
Practice Address - Street 1:8040 DIBBLE AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3243
Practice Address - Country:US
Practice Address - Phone:206-781-9656
Practice Address - Fax:206-706-7058
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 0947171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor