Healthcare Provider Details

I. General information

NPI: 1437932027
Provider Name (Legal Business Name): SARA STAINBROOK HURST FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date: 07/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 30TH AVE S UNIT B
SEATTLE WA
98144-3902
US

IV. Provider business mailing address

1316 30TH AVE S UNIT B
SEATTLE WA
98144-3902
US

V. Phone/Fax

Practice location:
  • Phone: 480-201-7182
  • Fax:
Mailing address:
  • Phone: 480-201-7182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61472793
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: