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General NPI Number Information
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NPI Number | 1821582313
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Entity Type | Individual
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Provider Name | SARAH FATOOL
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Gender | Female
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 903 S ADAMS ST
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City | RITZVILLE
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State | WA
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Zip | 99169-2227
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Country | US
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Telephone | 509-569-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 1148 BROADWAY STE 100
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City | TACOMA
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State | WA
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Zip | 98402-3518
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD61247959
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 94-09637
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License Number State | KS
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