Healthcare Provider Details

I. General information

NPI: 1124008743
Provider Name (Legal Business Name): SARA JENNIFER WEELBORG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 PACIFIC AVE STE 525
TACOMA WA
98402-4417
US

IV. Provider business mailing address

4240 MEMORY LN W
UNIVERSITY PLACE WA
98466-1125
US

V. Phone/Fax

Practice location:
  • Phone: 253-320-5844
  • Fax: 888-959-9016
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP 30007111
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAP30007111
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: