Provider Demographics
NPI:1497472815
Name:GATTIS, SARAH (ARNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GATTIS
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 1:376 NW 112TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-4841
Mailing Address - Country:US
Mailing Address - Phone:206-920-2207
Mailing Address - Fax:
Practice Address - Street 1:4225 HOYT AVE STE D
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2351
Practice Address - Country:US
Practice Address - Phone:425-317-8025
Practice Address - Fax:425-317-9516
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61362965363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP61362965OtherWASHINGTON STATE NURSING QUALITY ASSURANCE COMMISSION
WA1045098Medicaid