Provider Demographics
NPI:1063203842
Name:EDEN, SARAH (MOT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:EDEN
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13931 34TH DR SE UNIT A
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-4671
Mailing Address - Country:US
Mailing Address - Phone:505-321-6859
Mailing Address - Fax:
Practice Address - Street 1:20818 44TH AVE W STE 270-P
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-7709
Practice Address - Country:US
Practice Address - Phone:425-672-2716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT61646171225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist