Basic Information
| Provider Information | |||||||||
| NPI: | 1871069336 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | MARY | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19425 BUTCHER CREEK RD | ||||||||
| Address2: | |||||||||
| City: | LEAVENWORTH | ||||||||
| State: | WA | ||||||||
| PostalCode: | 988269238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5096796227 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1230 MONITOR ST | ||||||||
| Address2: | |||||||||
| City: | WENATCHEE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 988013534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093001221 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2018 | ||||||||
| LastUpdateDate: | 10/22/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | RN60122959 | WA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.