Provider Demographics
NPI:1134106115
Name:DICUGNO, SARAH B (ARNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:DICUGNO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1706 MERIDIAN S
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-7516
Mailing Address - Country:US
Mailing Address - Phone:253-848-8797
Mailing Address - Fax:253-446-3239
Practice Address - Street 1:10004 204TH AVE E
Practice Address - Street 2:SUITE 1300
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-6535
Practice Address - Country:US
Practice Address - Phone:253-848-8797
Practice Address - Fax:253-826-1264
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2011-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WARN00123662163WP0200X
WAAP30006255363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics