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General NPI Number Information
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NPI Number | 1134726979
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Entity Type | Individual
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Provider Name | SARA ELLER ARRT(R)(M)(CT)
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Gender | Female
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | BUILDING 6905 MCBH
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City | PEARL HARBOR
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State | HI
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Zip | 96734
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Country | US
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Telephone | 808-257-3365
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Fax |
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Provider Business Mailing Address
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Address Line | 8326 SILVERDALE WAY NW # B
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City | SILVERDALE
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State | WA
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Zip | 98383-8506
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Country | US
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Telephone | 931-200-4971
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 389692
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License Number State | WA
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