Provider Demographics
NPI:1609520592
Name:BRADFORD, SARAH ANNA (NP-C)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANNA
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:WA
Mailing Address - Zip Code:98541-9353
Mailing Address - Country:US
Mailing Address - Phone:360-346-2222
Mailing Address - Fax:360-346-2191
Practice Address - Street 1:600 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:WA
Practice Address - Zip Code:98541-9560
Practice Address - Country:US
Practice Address - Phone:360-346-2222
Practice Address - Fax:360-346-2192
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61264708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily