Provider Demographics
NPI:1053686014
Name:DAUM, SARA MARGARET (LMP, CPMT)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:MARGARET
Last Name:DAUM
Suffix:
Gender:F
Credentials:LMP, CPMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 N 50TH ST
Mailing Address - Street 2:#206
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6038
Mailing Address - Country:US
Mailing Address - Phone:206-941-2243
Mailing Address - Fax:
Practice Address - Street 1:4426 BURKE AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7536
Practice Address - Country:US
Practice Address - Phone:206-941-2243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023714225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist