Provider Demographics
NPI:1528398997
Name:THORNTON, SARA MAIRE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MAIRE
Last Name:THORNTON
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 1:11010 E FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4684
Mailing Address - Country:US
Mailing Address - Phone:509-777-2225
Mailing Address - Fax:509-777-2227
Practice Address - Street 1:100 N MULLAN RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6859
Practice Address - Country:US
Practice Address - Phone:509-777-2225
Practice Address - Fax:509-777-2227
Is Sole Proprietor?:No
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60074586174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist