Provider Demographics
NPI:1821401175
Name:PATTEN, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PATTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12406 172ND ST E
Mailing Address - Street 2:APT B102
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-9190
Mailing Address - Country:US
Mailing Address - Phone:678-899-5019
Mailing Address - Fax:
Practice Address - Street 1:12406 172ND ST E
Practice Address - Street 2:APT B102
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-9190
Practice Address - Country:US
Practice Address - Phone:678-899-5019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP1 60430818225200000X
KS14-02267225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant