Provider Demographics
NPI:1023466257
Name:MCCONAHAY, SARAH (LMT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCCONAHAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 OHANA CT
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-5459
Mailing Address - Country:US
Mailing Address - Phone:907-204-0717
Mailing Address - Fax:
Practice Address - Street 1:3316 OHANA CT
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5459
Practice Address - Country:US
Practice Address - Phone:907-204-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101349225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist