MEDICARE: SARAH D CHISHOLM PT

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	225100000X	Physical Therapist	PT00007613	WA

General Provider Information

NPI Number	:	1508806258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH D CHISHOLM PT

Provider Business Mailing Address
First Line	:	2607 S SOUTHEAST BLVD STE B211
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-7614
Country	:	US
Telephone Number	:	509-443-4357
Fax Number	:	509-242-3592

Provider Business Practice Location Address
First Line	:	2607 S SOUTHEAST BLVD STE B211
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-7614
Country	:	US
Telephone Number	:	509-443-4357
Fax Number	:	509-242-3592

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	05/21/2022

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