Provider Demographics
NPI:1174011621
Name:PRIOR, SARAH J (MA 00013018)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:PRIOR
Suffix:
Gender:F
Credentials:MA 00013018
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:ROESTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA 00013018
Mailing Address - Street 1:5224 N VISTA GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:OTIS ORCHARDS
Mailing Address - State:WA
Mailing Address - Zip Code:99027-9110
Mailing Address - Country:US
Mailing Address - Phone:509-868-5256
Mailing Address - Fax:
Practice Address - Street 1:100 N MULLAN RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6859
Practice Address - Country:US
Practice Address - Phone:509-777-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013018225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist