Provider Demographics
NPI:1508806258
Name:CHISHOLM, SARAH D (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:D
Last Name:CHISHOLM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:D
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2607 S SOUTHEAST BLVD STE B211
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7614
Mailing Address - Country:US
Mailing Address - Phone:509-443-4357
Mailing Address - Fax:509-242-3592
Practice Address - Street 1:2607 S SOUTHEAST BLVD STE B211
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-7614
Practice Address - Country:US
Practice Address - Phone:509-443-4357
Practice Address - Fax:509-242-3592
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8802066Medicare PIN