Provider Demographics
NPI:1114263035
Name:AYARS, SARA SWEENEY
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SWEENEY
Last Name:AYARS
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 1:205 5TH AVE S APT 6
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6538
Mailing Address - Country:US
Mailing Address - Phone:425-761-8543
Mailing Address - Fax:
Practice Address - Street 1:16411 NE 24TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-2427
Practice Address - Country:US
Practice Address - Phone:425-456-5732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60167983235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist