Provider Demographics
NPI:1114033149
Name:BLUM, SARAH LEAH (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LEAH
Last Name:BLUM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 O ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4645
Mailing Address - Country:US
Mailing Address - Phone:253-939-8796
Mailing Address - Fax:253-735-4445
Practice Address - Street 1:303 O ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4645
Practice Address - Country:US
Practice Address - Phone:253-939-8796
Practice Address - Fax:253-735-4445
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00046618163WP0808X
WAAP30004911163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB20295Medicare PIN
WAP08239Medicare UPIN