Provider Demographics
NPI:1578800124
Name:LEPPERT, SARAH LOUISE (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISE
Last Name:LEPPERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LOUISE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:14841 179TH AVE SE SUITE 210
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272
Mailing Address - Country:US
Mailing Address - Phone:360-217-1155
Mailing Address - Fax:360-217-1154
Practice Address - Street 1:14720 MAIN STREET NE # 109
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-8460
Practice Address - Country:US
Practice Address - Phone:425-788-4889
Practice Address - Fax:425-844-6116
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60302796363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant