Provider Demographics
NPI:1497160170
Name:COULTAS, SARAH (ND)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:COULTAS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-5852 ALII DR
Mailing Address - Street 2:SUITE 166
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1310
Mailing Address - Country:US
Mailing Address - Phone:808-320-0103
Mailing Address - Fax:
Practice Address - Street 1:75-5852 ALII DR
Practice Address - Street 2:SUITE 166
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1310
Practice Address - Country:US
Practice Address - Phone:808-320-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-21
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND260175F00000X
WANT60466197175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath