Basic Information
| Provider Information | |||||||||
| NPI: | 1811990385 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MICHAEL | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | KIM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 HILLCREST DR | ||||||||
| Address2: | |||||||||
| City: | SELAH | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989421548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5096979256 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 401 BUSTER RD | ||||||||
| Address2: | |||||||||
| City: | TOPPENISH | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989489792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098651703 | ||||||||
| FaxNumber: | 5098658753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PH00051306 | WA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.