Provider Demographics
NPI:1427233261
Name:SABOTA, JILL (RN)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:SABOTA
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 1:7808 E WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-1615
Mailing Address - Country:US
Mailing Address - Phone:509-993-2154
Mailing Address - Fax:509-210-4576
Practice Address - Street 1:7808 E WOODVIEW DR
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-1615
Practice Address - Country:US
Practice Address - Phone:509-993-2154
Practice Address - Fax:509-210-4576
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00153517163W00000X
IDN-35216163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse