Provider Demographics
NPI:1134646508
Name:SCHAB, TRISTIN FAWN (ARNP)
Entity Type:Individual
Prefix:
First Name:TRISTIN
Middle Name:FAWN
Last Name:SCHAB
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 1:85704 E SAGEBRUSH RD
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2421
Mailing Address - Country:US
Mailing Address - Phone:509-948-6565
Mailing Address - Fax:
Practice Address - Street 1:1776 FOWLER ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4833
Practice Address - Country:US
Practice Address - Phone:509-735-9355
Practice Address - Fax:509-222-1151
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-27
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00166074163W00000X
WAAP60818380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse