1295800621 NPI number — EVELYN ROSALIE SABROE ARNP

Table of content: ALEXA GARCIA (NPI 1194196816)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295800621 NPI number — EVELYN ROSALIE SABROE ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SABROE
Provider First Name:
EVELYN
Provider Middle Name:
ROSALIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295800621
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1175 CENTER DR
Provider Second Line Business Mailing Address:
STE 130
Provider Business Mailing Address City Name:
DUPONT
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98327-7733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-964-5260
Provider Business Mailing Address Fax Number:
253-964-5266

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1175 CENTER DR
Provider Second Line Business Practice Location Address:
STE 130
Provider Business Practice Location Address City Name:
DUPONT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98327-7733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-964-5260
Provider Business Practice Location Address Fax Number:
253-964-5266
Provider Enumeration Date:
11/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN00156838 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP2300X , with the licence number: AP30007427 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8944073 . This is a "STATE CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9651225 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0218704 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00369741 . This is a "RAILROAD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0229196 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com