Provider Demographics
NPI:1154649192
Name:DIBLE, SARAH W (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:W
Last Name:DIBLE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:R
Other - Last Name:WECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14504 NW 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-8006
Mailing Address - Country:US
Mailing Address - Phone:360-601-7485
Mailing Address - Fax:503-597-5324
Practice Address - Street 1:300 E 24TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3214
Practice Address - Country:US
Practice Address - Phone:360-798-7625
Practice Address - Fax:360-553-4165
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist