Provider Demographics
NPI:1871041988
Name:WADDA, SAINABOU (DNP, ARNP)
Entity Type:Individual
Prefix:
First Name:SAINABOU
Middle Name:
Last Name:WADDA
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:SAINABOU
Other - Middle Name:
Other - Last Name:JOBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8980 161ST AVE NE STE 400
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:425-992-2738
Mailing Address - Fax:425-259-1154
Practice Address - Street 1:22850 NE 8TH ST STE 103
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7256
Practice Address - Country:US
Practice Address - Phone:425-488-4988
Practice Address - Fax:425-488-4993
Is Sole Proprietor?:No
Enumeration Date:2016-09-17
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60665719363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1871041988Medicaid
WA1871041988Medicaid