MEDICARE: SARAH WAMPOLD ORR

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	363AM0700X	Medical Physician Assistant	PA1024	ID

General Provider Information

NPI Number	:	1427353721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH WAMPOLD ORR

Provider Business Mailing Address
First Line	:	1828 S MILLENIUM WAY STE 300
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-5036
Country	:	US
Telephone Number	:	208-895-8775
Fax Number	:

Provider Business Practice Location Address
First Line	:	1828 S MILLENIUM WAY STE 300
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-5036
Country	:	US
Telephone Number	:	208-895-8775
Fax Number	:

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

Provider Enumeration Date	:	01/18/2011
Last Update Date	:	08/05/2024

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Directions to “ SARAH WAMPOLD ORR ” Practice Location

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