Doctor Name: | SARAH MAY LIDREN |
NPI Number: | 1093929671 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.P. |
License Number: | MA00023493 |
Business Practice Address: | 3211 56th St Nw Gig Harbor, WA - 983351359 |
Business Phone Number: | 2538533434 |
Business Fax Number: | |
Mailing Address: | 4314 Beckonridge Dr W Apt B, UNIVERSITY PLACE |
State: | WA |
Postal Code: | 984661369 |
Phone Number: | 2535077569 |
Fax Number: | |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA00023493 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |