Provider Demographics
NPI:1619990017
Name:LORION, SARAH JESSY (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JESSY
Last Name:LORION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:S
Other - Middle Name:JESSY
Other - Last Name:LORION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1517
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0410
Mailing Address - Country:US
Mailing Address - Phone:877-708-1119
Mailing Address - Fax:208-691-7960
Practice Address - Street 1:1130 W PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8780
Practice Address - Country:US
Practice Address - Phone:208-209-0288
Practice Address - Fax:208-209-0289
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM7702207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID805432900Medicaid
ID11416371Medicare PIN
F93769Medicare UPIN