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1154649192 NPI number — SARAH W DIBLE MSPT

NPI Number: 1154649192
Health Care Provider/Practitioner: SARAH W DIBLE MSPT

Information about “1154649192” NPI (SARAH W DIBLE MSPT) exists in 1154649192 in HTML format HTML  |  1154649192 in plain Text format TXT  |  1154649192 in PDF (Portable Document Format) PDF  |  1154649192 in an XML format XML  formats.

NPI Number : 1154649192 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154649192",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DIBLE",
    "FirstName": "SARAH",
    "MiddleName": "W",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MSPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WECKER",
    "OtherFirstName": "SARAH",
    "OtherMiddleName": "R.",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "14504 NW 20TH AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VANCOUVER",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98685-8006",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "360-601-7485",
    "MailingAddressFaxNumber": "503-597-5324",
    "FirstLinePracticeLocationAddress": "300 E 24TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VANCOUVER",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98663-3214",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-798-7625",
    "PracticeLocationAddressFaxNumber": "360-553-4165",
    "EnumerationDate": "05/14/2010",
    "LastUpdateDate": "01/04/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "7729",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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