Provider Demographics
NPI:1063499960
Name:RAY, SARAH K (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:K
Last Name:RAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1802 S UNION AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1947
Mailing Address - Country:US
Mailing Address - Phone:253-759-1310
Mailing Address - Fax:253-759-1330
Practice Address - Street 1:1802 S UNION AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1947
Practice Address - Country:US
Practice Address - Phone:253-759-1310
Practice Address - Fax:253-759-1330
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA6719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7130487Medicaid
WA8857007Medicare PIN
WA6063260001Medicare NSC