Provider Demographics
NPI:1407064249
Name:VALEOS, SARAH R (LMP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:R
Last Name:VALEOS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:R
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:612 SIERRA ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8681
Mailing Address - Country:US
Mailing Address - Phone:360-319-6755
Mailing Address - Fax:
Practice Address - Street 1:1470 ELLIS ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4904
Practice Address - Country:US
Practice Address - Phone:360-319-6755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014036225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist