Provider Demographics
NPI:1669679346
Name:MCLENDON, SABRINA (LMP)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:
Last Name:MCLENDON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 S MERIDIAN STE D
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-5972
Mailing Address - Country:US
Mailing Address - Phone:360-504-8169
Mailing Address - Fax:253-447-1357
Practice Address - Street 1:4115 S MERIDIAN STE D
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-5972
Practice Address - Country:US
Practice Address - Phone:360-504-8169
Practice Address - Fax:253-447-1357
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022293174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA604890096OtherAETNA