Provider Demographics
NPI:1235578089
Name:CRISSINGER, SARAH ELLEN (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELLEN
Last Name:CRISSINGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6630 NE 202ND ST
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-8625
Mailing Address - Country:US
Mailing Address - Phone:425-381-9953
Mailing Address - Fax:
Practice Address - Street 1:6630 NE 202ND ST
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-8625
Practice Address - Country:US
Practice Address - Phone:425-381-9953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60245875163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse