Provider Demographics
NPI:1629417241
Name:FAIRCHILD FRADETTE, SARAH ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:FAIRCHILD FRADETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:FAIRCHILD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8980 161ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7554
Mailing Address - Country:US
Mailing Address - Phone:425-899-2273
Mailing Address - Fax:425-899-2272
Practice Address - Street 1:8980 161ST AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7554
Practice Address - Country:US
Practice Address - Phone:425-899-2273
Practice Address - Fax:425-899-2272
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60688700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine