Provider Demographics
NPI:1245871441
Name:SAGE COUNTERSTRAIN, PLLC
Entity type:Organization
Organization Name:SAGE COUNTERSTRAIN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNDT
Authorized Official - Suffix:
Authorized Official - Credentials:MPST, JSCC
Authorized Official - Phone:360-869-6400
Mailing Address - Street 1:PO BOX 260
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-0260
Mailing Address - Country:US
Mailing Address - Phone:360-869-6400
Mailing Address - Fax:
Practice Address - Street 1:SOUNDVIEW CENTER
Practice Address - Street 2:432 3RD ST
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260
Practice Address - Country:US
Practice Address - Phone:360-869-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy