Provider Demographics
NPI:1902249410
Name:GAGNEBIN, SARAH RASHELLE (LMP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RASHELLE
Last Name:GAGNEBIN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:RASHELLE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:1124 S PINES RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-5427
Mailing Address - Country:US
Mailing Address - Phone:509-922-1909
Mailing Address - Fax:509-922-6648
Practice Address - Street 1:1124 S PINES RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-5427
Practice Address - Country:US
Practice Address - Phone:509-922-1909
Practice Address - Fax:509-922-6648
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019400225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist