Provider Demographics
NPI:1891361747
Name:STOCKWELL, SARAH BLEY (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BLEY
Last Name:STOCKWELL
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 1:1869 4TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-4915
Mailing Address - Country:US
Mailing Address - Phone:412-874-9406
Mailing Address - Fax:
Practice Address - Street 1:3528 S FERDINAND ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1734
Practice Address - Country:US
Practice Address - Phone:412-874-9406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61016040163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool