Provider Demographics
NPI:1770896235
Name:MENASHE, SARAH JOY (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JOY
Last Name:MENASHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVENUE W
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W
Practice Address - Street 2:SUITE 210
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4748
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD602817552085P0229X, 2085R0202X
PAMT1904832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8923928OtherPTAN-MEDICAL IMAGING ON 1ST
WA2018752Medicaid
WAG8923929OtherPTAN-TACOMA RADIOLOGICAL ASSOCIATES, KING CO
WAG8923930OtherPTAN-TACOMA RADIOLOGICAL ASSOCIATES, PIERCE CO
WAG8923928OtherPTAN-MEDICAL IMAGING ON 1ST
WAG8923929OtherPTAN-TACOMA RADIOLOGICAL ASSOCIATES, KING CO
WAP01775432Medicare PIN
WAG8961618Medicare PIN
WAG8961619Medicare PIN
WAG8961617Medicare PIN
WAP01775486Medicare PIN