MEDICARE: SARA HAYES SARA HAYES, L.M.P.

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	174400000X	Specialist	MA 00017836	WA

General Provider Information

NPI Number	:	1629216494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA HAYES SARA HAYES, L.M.P.

Provider Business Mailing Address
First Line	:	PO BOX 1962
Second Line	:
City	:	SNOQUALMIE
State	:	WA
Zip	:	98065-1962
Country	:	US
Telephone Number	:	425-888-1018
Fax Number	:	425-888-0636

Provider Business Practice Location Address
First Line	:	231 BENDIGO BLVD N
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-8259
Country	:	US
Telephone Number	:	425-888-1018
Fax Number	:	425-888-0636

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

Provider Enumeration Date	:	02/01/2009
Last Update Date	:	02/01/2009

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