Provider Demographics
NPI:1093016198
Name:NULLE, SARA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:MARIE
Last Name:NULLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 2ND AVE W APT 709
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-4127
Mailing Address - Country:US
Mailing Address - Phone:970-390-5734
Mailing Address - Fax:
Practice Address - Street 1:925 8TH AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-6304
Practice Address - Country:US
Practice Address - Phone:206-957-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60191431111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor