Healthcare Provider Details

I. General information

NPI: 1710454137
Provider Name (Legal Business Name): SARAH CHOU PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 03/07/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 112TH AVE NE STE C210
BELLEVUE WA
98004-3740
US

IV. Provider business mailing address

7683 SE 27TH ST STE 254
MERCER ISLAND WA
98040-2804
US

V. Phone/Fax

Practice location:
  • Phone: 425-999-3580
  • Fax: 425-999-3122
Mailing address:
  • Phone: 425-999-3580
  • Fax: 425-999-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA61029000
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: