Provider Demographics
NPI:1619114543
Name:FRAZIER, SARAH JEAN (LMP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JEAN
Other - Last Name:FREDERICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:323 S MARY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-9261
Mailing Address - Country:US
Mailing Address - Phone:509-668-0934
Mailing Address - Fax:
Practice Address - Street 1:667 GRANT RD
Practice Address - Street 2:SUITE 3
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-7818
Practice Address - Country:US
Practice Address - Phone:509-668-0934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2012-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60065988225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist