Healthcare Provider Details

I. General information

NPI: 1316216583
Provider Name (Legal Business Name): SARAJANE PRISCILLA HUFF LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2011
Last Update Date: 12/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 NE 27TH ST
RENTON WA
98056-2234
US

IV. Provider business mailing address

2311 NE 27TH ST
RENTON WA
98056-2234
US

V. Phone/Fax

Practice location:
  • Phone: 206-714-7391
  • Fax:
Mailing address:
  • Phone: 206-714-7391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA 00020472
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: