Provider Demographics
NPI:1780482885
Name:MEEHAN, SARAH LOUISE (LMT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISE
Last Name:MEEHAN
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 COVENTRY LN
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-6843
Mailing Address - Country:US
Mailing Address - Phone:971-361-2196
Mailing Address - Fax:
Practice Address - Street 1:4845 BROADMOOR BLVD STE 103
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-7076
Practice Address - Country:US
Practice Address - Phone:971-361-2196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMASS.MA.61671438225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist