Provider Demographics
NPI:1558309070
Name:LAY, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LAY
Suffix:
Gender:F
Credentials:
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 808
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-0808
Mailing Address - Country:US
Mailing Address - Phone:509-935-8424
Mailing Address - Fax:509-935-8402
Practice Address - Street 1:518 E CLAY AVE
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-8947
Practice Address - Country:US
Practice Address - Phone:509-935-8424
Practice Address - Fax:509-935-8402
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8987207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85732YOtherBLUE CROSS BLUE SHIELD
TX145434001Medicaid
TX8145K5Medicare PIN
TXK8987Medicare UPIN
TX85732YOtherBLUE CROSS BLUE SHIELD