Provider Demographics
NPI:1093461535
Name:EDWARDS, SARA DAWN
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:DAWN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 W TRINITY PL
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-2224
Mailing Address - Country:US
Mailing Address - Phone:509-953-5784
Mailing Address - Fax:
Practice Address - Street 1:1510 N ARGONNE RD STE F
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2572
Practice Address - Country:US
Practice Address - Phone:509-279-2867
Practice Address - Fax:509-279-2419
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60763447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist