Basic Information
| Provider Information | |||||||||
| NPI: | 1538471875 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LARY | ||||||||
| FirstName: | SARA | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | FILE # 54701 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900744701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095583111 | ||||||||
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| Practice Location | |||||||||
| Address1: | 21601 76TH AVE W | ||||||||
| Address2: | |||||||||
| City: | EDMONDS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980267507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256404000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2010 | ||||||||
| LastUpdateDate: | 08/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | OP60325677 | WA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | DO173902 | OR | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 02006894A | IN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 20A11296 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | O-1606 | ID | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 2020012664 | MO | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | S7085 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 036144563 | IL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.