Healthcare Provider Details

I. General information

NPI: 1053072751
Provider Name (Legal Business Name): SAVATHDY IM ARNP, PMHNP-BC, CARN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 AUBURN WAY S STE 1B
AUBURN WA
98002-5451
US

IV. Provider business mailing address

230 AUBURN WAY S STE 1B
AUBURN WA
98002-5451
US

V. Phone/Fax

Practice location:
  • Phone: 253-374-7932
  • Fax: 949-703-7387
Mailing address:
  • Phone: 253-374-7932
  • Fax: 949-703-7387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61339231
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: