Healthcare Provider Details

I. General information

NPI: 1629750070
Provider Name (Legal Business Name): SARAH WYNELLE BERNHARDS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16549 AURORA AVE N
SHORELINE WA
98133-5308
US

IV. Provider business mailing address

PO BOX 3007
SEATTLE WA
98114-3007
US

V. Phone/Fax

Practice location:
  • Phone: 206-788-3757
  • Fax:
Mailing address:
  • Phone: 206-533-2600
  • Fax: 206-962-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61471480
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: