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General NPI Number Information
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NPI Number | 1538656442
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Entity Type | Individual
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Provider Name | SARAH DALTON BLOOM ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 04/16/2018
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Provider Practice Location Address
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Address Line | 2101 NE 139TH ST STE 285
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City | VANCOUVER
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State | WA
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Zip | 98686-2326
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Country | US
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Telephone | 360-839-4532
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Fax | 360-639-8432
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Provider Business Mailing Address
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Address Line | 13311 NE 9TH CT
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City | VANCOUVER
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State | WA
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Zip | 98685-2633
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Country | US
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Telephone | 360-513-8089
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60816459
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License Number State | WA
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