Provider Demographics
NPI:1295011534
Name:DEBROUX, SOPHIA HELENE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:HELENE
Last Name:DEBROUX
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 1:18425 E EAGLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:WA
Mailing Address - Zip Code:99021-5038
Mailing Address - Country:US
Mailing Address - Phone:509-238-3285
Mailing Address - Fax:
Practice Address - Street 1:18425 E EAGLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:MEAD
Practice Address - State:WA
Practice Address - Zip Code:99021-5038
Practice Address - Country:US
Practice Address - Phone:509-238-3285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60247942363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health