Doctor Name: | SARAH PEDERSEN |
NPI Number: | 1023494226 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | IN PROGRESS |
Business Practice Address: | 914 South Scheuber Rd Centralia, WA - 98531 |
Business Phone Number: | 3607362803 |
Business Fax Number: | |
Mailing Address: | 4014 Shady Springs, SEABROOK |
State: | TX |
Postal Code: | 77586 |
Phone Number: | 7138985967 |
Fax Number: | |
NPI Enumeration Date: | 08/11/2015 |
NPI Last Update Date: | 08/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | IN PROGRESS |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |