Provider Demographics
NPI:1154716199
Name:VEGA, SARAH TERESITA (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:TERESITA
Last Name:VEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 164TH ST SE STE 100
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6316
Mailing Address - Country:US
Mailing Address - Phone:425-354-4296
Mailing Address - Fax:
Practice Address - Street 1:805 164TH ST SE STE 100
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-6316
Practice Address - Country:US
Practice Address - Phone:425-354-4296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61531892208000000X
CAA1441232080C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics