Provider Demographics
NPI:1164704169
Name:PERLMAN, SARAH MATTHEA (CNP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MATTHEA
Last Name:PERLMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1138
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:WA
Mailing Address - Zip Code:98356-0019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1420 AHTANUM RIDGE DR
Practice Address - Street 2:
Practice Address - City:UNION GAP
Practice Address - State:WA
Practice Address - Zip Code:98903-1839
Practice Address - Country:US
Practice Address - Phone:509-454-7700
Practice Address - Fax:509-454-7710
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRX.12563-EX1363LF0000X
WAAP61622317164W00000X, 363LF0000X
OHCOA.12563-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0054620Medicaid
OH0054620Medicaid