Provider Demographics
NPI:1619990017
Name:LORION, SARAH JESSY (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JESSY
Last Name:LORION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:S
Other - Middle Name:JESSY
Other - Last Name:LORION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:320 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3915
Mailing Address - Country:US
Mailing Address - Phone:208-691-7960
Mailing Address - Fax:208-691-7960
Practice Address - Street 1:1986 W HAYDEN AVE
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-7412
Practice Address - Country:US
Practice Address - Phone:208-666-0909
Practice Address - Fax:208-966-4441
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM7702207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID805432900Medicaid
ID11416371Medicare PIN
F93769Medicare UPIN