Basic Information
Provider Information
NPI: 1285137091
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEEKS
FirstName: SARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1211 24TH ST
Address2:  
City: ANACORTES
State: WA
PostalCode: 982212562
CountryCode: US
TelephoneNumber: 3602933101
FaxNumber: 3602933839
Practice Location
Address1: 1213 24TH ST STE 100
Address2:  
City: ANACORTES
State: WA
PostalCode: 982212595
CountryCode: US
TelephoneNumber: 3602933101
FaxNumber: 3602933839
Other Information
ProviderEnumerationDate: 03/18/2018
LastUpdateDate: 08/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XOP61276130WAY Allopathic & Osteopathic PhysiciansFamily Medicine 
390200000X CON Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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