Provider Demographics
NPI:1174021679
Name:CHEBERT, SARAH JULIANNE (LMP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JULIANNE
Last Name:CHEBERT
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:CLE ELUM
Mailing Address - State:WA
Mailing Address - Zip Code:98922-0845
Mailing Address - Country:US
Mailing Address - Phone:509-674-5057
Mailing Address - Fax:509-674-6946
Practice Address - Street 1:202 W 1ST ST STE 1
Practice Address - Street 2:
Practice Address - City:CLE ELUM
Practice Address - State:WA
Practice Address - Zip Code:98922-1154
Practice Address - Country:US
Practice Address - Phone:509-674-5057
Practice Address - Fax:509-674-6946
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60687334225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist