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General NPI Number Information
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NPI Number | 1104423649
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Entity Type | Individual
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Provider Name | SARA E JERGER CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 300 SW 7TH ST
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City | RENTON
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State | WA
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Zip | 98057-2307
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Country | US
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Telephone | 425-204-3365
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Fax |
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Provider Business Mailing Address
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Address Line | 4634 S AUSTIN ST
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City | SEATTLE
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State | WA
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Zip | 98118-3924
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Country | US
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Telephone | 206-499-5811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | LL61057399
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License Number State | WA
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