Provider Demographics
NPI:1326077884
Name:HALL, SARAH C (DPT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:C
Last Name:HALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:C
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:11821 NE 128TH ST STE C
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7210
Practice Address - Country:US
Practice Address - Phone:425-285-1250
Practice Address - Fax:425-285-1255
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
WAPT 00010116225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0290908OtherDEPT. OF LABOR AND INDUSTRIES
WA8457947Medicaid
WA8457947Medicaid