Healthcare Provider Details

I. General information

NPI: 1245409531
Provider Name (Legal Business Name): SALLY ANN NEWBROUGH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 10/15/2023
Certification Date: 10/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 172ND ST NE
ARLINGTON WA
98223-8482
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 425-339-5412
  • Fax: 360-363-4750
Mailing address:
  • Phone: 425-304-8431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD60067482
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD60067482
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: