Healthcare Provider Details

I. General information

NPI: 1659747269
Provider Name (Legal Business Name): SARAH YEATES PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2015
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15015 SE 15TH ST
BELLEVUE WA
98007-5802
US

IV. Provider business mailing address

6516 128TH AVE SE
BELLEVUE WA
98006-4014
US

V. Phone/Fax

Practice location:
  • Phone: 608-293-1259
  • Fax:
Mailing address:
  • Phone: 608-293-1259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60596468
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: