Provider Demographics
NPI:1295800621
Name:SABROE, EVELYN ROSALIE (ARNP)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:ROSALIE
Last Name:SABROE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 CENTER DR
Mailing Address - Street 2:STE 130
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-7733
Mailing Address - Country:US
Mailing Address - Phone:253-964-5260
Mailing Address - Fax:253-964-5266
Practice Address - Street 1:1175 CENTER DR
Practice Address - Street 2:STE 130
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-7733
Practice Address - Country:US
Practice Address - Phone:253-964-5260
Practice Address - Fax:253-964-5266
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00156838163W00000X
WAAP30007427363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8944073OtherSTATE CRIME VICTIMS
WA9651225Medicaid
WA0218704OtherSTATE L&I
WAP00369741OtherRAILROAD
WA0229196OtherSTATE L&I
WA0229196OtherSTATE L&I
WA8944073OtherSTATE CRIME VICTIMS