Provider Demographics
NPI:1205243904
Name:CARNEY, SARA M (DPT, FAAOMPT, OCS)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:CARNEY
Suffix:
Gender:F
Credentials:DPT, FAAOMPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 140TH AVE NE
Mailing Address - Street 2:STE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-4571
Mailing Address - Country:US
Mailing Address - Phone:425-746-2475
Mailing Address - Fax:425-746-2471
Practice Address - Street 1:16406 7TH PL W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-8100
Practice Address - Country:US
Practice Address - Phone:425-245-8547
Practice Address - Fax:425-245-8548
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60479620225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA328719OtherL& I
WA328719OtherL& I
WAG8933389Medicare PIN