Provider Demographics
NPI:1871012674
Name:NIXON, SARAH ANN
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:NIXON
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 1:18407 PACIFIC AVE S STE A11
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-8374
Mailing Address - Country:US
Mailing Address - Phone:253-847-6000
Mailing Address - Fax:253-846-2757
Practice Address - Street 1:18407 PACIFIC AVE S STE A11
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8374
Practice Address - Country:US
Practice Address - Phone:253-847-6000
Practice Address - Fax:253-846-2757
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60769461225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist