Provider Demographics
NPI:1497898217
Name:MERICKEL, SARAH M (LMP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:MERICKEL
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:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-0541
Mailing Address - Country:US
Mailing Address - Phone:425-268-0981
Mailing Address - Fax:
Practice Address - Street 1:1621 FREEWAY DR STE 208
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2469
Practice Address - Country:US
Practice Address - Phone:425-268-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010563225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA116026OtherLABOR & INDUSTRIES
WABA9256OtherREGENCE BLUESHIELD