| Doctor Name: | MRS. SANDRA J MIRACLE |
| NPI Number: | 1750430252 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT00007782 |
| Business Practice Address: | 111 S 12th St Suite B Mount Vernon, WA - 982744000 |
| Business Phone Number: | 3604199300 |
| Business Fax Number: | 3604199301 |
| Mailing Address: | 10505 19th Ave Se, Suite B EVERETT |
| State: | WA |
| Postal Code: | 982084280 |
| Phone Number: | 4085700510 |
| Fax Number: | 4089454011 |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 08/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00007782 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |