MEDICARE: SARAH MICHELLE KING JOERGENSEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50.009714RX	OH

General Provider Information

NPI Number	:	1134962822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MICHELLE KING JOERGENSEN

Provider Business Mailing Address
First Line	:	7222 EUCLID AVE APT 203
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-4019
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7222 EUCLID AVE APT 203
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-4019
Country	:	US
Telephone Number	:	980-245-6720
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2024
Last Update Date	:	03/23/2026

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