Provider Demographics
NPI:1023349768
Name:SCHWAMPE, SARA JO (ATC, ATC/L)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JO
Last Name:SCHWAMPE
Suffix:
Gender:F
Credentials:ATC, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-4304
Mailing Address - Country:US
Mailing Address - Phone:360-710-6553
Mailing Address - Fax:
Practice Address - Street 1:902 CLINE AVE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4304
Practice Address - Country:US
Practice Address - Phone:360-710-6553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600471062255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer