Provider Demographics
NPI:1235403973
Name:ENERA, SARAH JOANNE (LMP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JOANNE
Last Name:ENERA
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 1:7511 GREENWOOD AVE N # 906
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4627
Mailing Address - Country:US
Mailing Address - Phone:425-623-6328
Mailing Address - Fax:
Practice Address - Street 1:414 NE RAVENNA BLVD
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6429
Practice Address - Country:US
Practice Address - Phone:425-623-6328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60260575174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist