Healthcare Provider Details

I. General information

NPI: 1578800124
Provider Name (Legal Business Name): SARAH LOUISE LEPPERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH LOUISE CARTER PA-C

II. Dates (important events)

Enumeration Date: 01/15/2013
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14720 MAIN STREET NE # 109
DUVALL WA
98019-8460
US

IV. Provider business mailing address

14841 179TH AVE SE SUITE 210
MONROE WA
98272
US

V. Phone/Fax

Practice location:
  • Phone: 425-788-4889
  • Fax: 425-844-6116
Mailing address:
  • Phone: 360-217-1155
  • Fax: 360-217-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60302796
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: