Provider Demographics
NPI:1700412756
Name:DREBIS, SARA JOY (RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JOY
Last Name:DREBIS
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 1:900 EAST BAY DR NE # A-205
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-3969
Mailing Address - Country:US
Mailing Address - Phone:360-704-8341
Mailing Address - Fax:360-357-2821
Practice Address - Street 1:1000 CHERRY ST SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1433
Practice Address - Country:US
Practice Address - Phone:360-349-0033
Practice Address - Fax:360-357-2821
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00138094163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse