Provider Demographics
NPI:1053304147
Name:BARNABY, SARA K (LMP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:K
Last Name:BARNABY
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 1:8511 CANYON RD E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-6317
Mailing Address - Country:US
Mailing Address - Phone:253-535-3931
Mailing Address - Fax:253-535-3948
Practice Address - Street 1:8511 CANYON RD E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-6317
Practice Address - Country:US
Practice Address - Phone:253-535-3931
Practice Address - Fax:253-535-3948
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020517225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA198445OtherDEPT OF L&I
WA2620RUOtherREGENCE B/S
WA8906260OtherCRIME VICTIMS