Provider Demographics
NPI:1629546882
Name:EGGERSTORFER, SARAH MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:EGGERSTORFER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:509-474-6842
Mailing Address - Fax:509-474-6606
Practice Address - Street 1:122 W 7TH AVE STE 232
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2354
Practice Address - Country:US
Practice Address - Phone:509-474-2041
Practice Address - Fax:509-474-4906
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60909303363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner