Healthcare Provider Details

I. General information

NPI: 1114873650
Provider Name (Legal Business Name): SADA MAY CONDON RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18223 RAMPART DR SE
YELM WA
98597-9018
US

IV. Provider business mailing address

18223 RAMPART DR SE
YELM WA
98597-9018
US

V. Phone/Fax

Practice location:
  • Phone: 360-292-5767
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60291578
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: