Provider Demographics
NPI:1275609968
Name:MCKINNEY, SARAH CHRISTINE (CD, RD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:CHRISTINE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:CD, RD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:CHRISTINE
Other - Last Name:LINDSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18473 134TH ST SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-8707
Mailing Address - Country:US
Mailing Address - Phone:425-327-6811
Mailing Address - Fax:
Practice Address - Street 1:14350 SE EASTGATE WAY
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-6458
Practice Address - Country:US
Practice Address - Phone:206-296-4920
Practice Address - Fax:206-296-0577
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001476133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8419723Medicaid