Provider Demographics
NPI:1770897233
Name:LASTER, SARAH RUTH (DDS)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:RUTH
Last Name:LASTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19723 HIGHWAY 99
Mailing Address - Street 2:STE A
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6079
Mailing Address - Country:US
Mailing Address - Phone:425-775-3456
Mailing Address - Fax:425-775-0716
Practice Address - Street 1:1769 NW KINGS BLVD
Practice Address - Street 2:#8
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-1905
Practice Address - Country:US
Practice Address - Phone:541-757-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX257051223G0001X
ORD96271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice