Provider Demographics
NPI:1861902207
Name:KOTLERMAN, SARAH LISA (DC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:LISA
Last Name:KOTLERMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13103 SUNDAY LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-8025
Mailing Address - Country:US
Mailing Address - Phone:360-982-1368
Mailing Address - Fax:
Practice Address - Street 1:13103 SUNDAY LN
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-8025
Practice Address - Country:US
Practice Address - Phone:360-982-1368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACHIR.CH.60789255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor