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NPI Code Detail

MEDICARE: SARAH MILLISSA DEAN LPN

MEDICARE:   SARAH MILLISSA DEAN  LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLP00052643WA

General Provider Information

NPI Number : 1023084050
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH MILLISSA DEAN LPN
Provider Business Mailing Address
First Line : 2562 LAKE WHATCOM BLVD
Second Line :
City : BELLINGHAM
State : WA
Zip : 98229
Country : US
Telephone Number : 360-647-8867
Fax Number :
Provider Business Practice Location Address
First Line : 609 NORTH SHORE DRIVE
Second Line :
City : BELLINGHAM
State : WA
Zip : 98226-4414
Country : US
Telephone Number : 360-676-6000
Fax Number : 360-676-6006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2006
Last Update Date : 07/08/2007

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Directions to “ SARAH MILLISSA DEAN LPN” Practice Location

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