Sara Jesse Harding
Individual provider Active NPI Physical Therapy Assistant · Shoshone, ID
NPI 1972003291 · NPPES record last updated Feb 13, 2018
Key facts
- NPI
- 1972003291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 5578 (ID)
- Practice address
- 511 E 4TH St
Shoshone, ID 83352-5380 - Phone
- (208) 886-2228
- NPI assigned
- Feb 13, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5578 | ID | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5578 | ID | Yes |
Addresses
Primary practice location
511 E 4TH St
Shoshone, ID 83352-5380
Mailing address
25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Other providers in Shoshone, ID
- Katelyn Rose Denison
- Family Health Services Corporation
- Family Health Services Corporation
- Gooding Pharmacy Inc
- Barbara Hapayan
- Blaine Hawkes
- Katie S Hays
- Keith E Davis
- Matthew E. Kent
- Lincoln Community Health
All providers in Shoshone, ID · Physical Therapy Assistant in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.