Provider Demographics
NPI:1841668159
Name:NILES, SARAH K (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:K
Last Name:NILES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:K
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:550 17TH AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5877
Mailing Address - Country:US
Mailing Address - Phone:206-661-6100
Mailing Address - Fax:206-602-6021
Practice Address - Street 1:550 17TH AVE STE 240
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5877
Practice Address - Country:US
Practice Address - Phone:206-661-6100
Practice Address - Fax:206-602-6021
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60587015363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant