Provider Demographics
NPI:1629216494
Name:HAYES, SARA (SARA HAYES, LMP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:SARA HAYES, LMP
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 1962
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-1962
Mailing Address - Country:US
Mailing Address - Phone:425-888-1018
Mailing Address - Fax:425-888-0636
Practice Address - Street 1:231 BENDIGO BLVD N
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8259
Practice Address - Country:US
Practice Address - Phone:425-888-1018
Practice Address - Fax:425-888-0636
Is Sole Proprietor?:No
Enumeration Date:2009-02-01
Last Update Date:2009-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00017836174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist