Provider Demographics
NPI:1770850570
Name:LAHNERT, SARAH JONES (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JONES
Last Name:LAHNERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 YAKIMA AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4499
Mailing Address - Country:US
Mailing Address - Phone:253-426-4697
Mailing Address - Fax:
Practice Address - Street 1:1802 YAKIMA AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4499
Practice Address - Country:US
Practice Address - Phone:253-426-4697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1127363AM0700X
WAPA60514733363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1585066Medicaid
AKK165097Medicare PIN
AK0361450001Medicare NSC