Healthcare Provider Details

I. General information

NPI: 1649369505
Provider Name (Legal Business Name): SARAH E SCARBOROUGH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH E SCARBOROUGH NP

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 NE 5TH AVE
MILTON OR
97862-1799
US

IV. Provider business mailing address

55 W TIETAN ST
WALLA WALLA WA
99362-4498
US

V. Phone/Fax

Practice location:
  • Phone: 541-938-3314
  • Fax: 541-938-4449
Mailing address:
  • Phone: 509-525-3720
  • Fax: 509-522-1592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30006616
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: