Provider Demographics
NPI:1588038228
Name:BIRTELL, SARA (RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BIRTELL
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 1:34831 RHODODENDRON DR SE
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9076
Mailing Address - Country:US
Mailing Address - Phone:425-831-4142
Mailing Address - Fax:
Practice Address - Street 1:34831 RHODODENDRON DR SE
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9076
Practice Address - Country:US
Practice Address - Phone:425-831-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00119449163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool