MEDICARE: MRS. SARAH N BARQUERO RN

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
1	163W00000X	Registered Nurse	RN60236056	WA

General Provider Information

NPI Number	:	1205177730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH N BARQUERO RN

Provider Business Mailing Address
First Line	:	2306 NE 135TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-3349
Country	:	US
Telephone Number	:	425-941-6328
Fax Number	:

Provider Business Practice Location Address
First Line	:	1242 18TH AVE E
Second Line	:	STEVENS ELEMENTARY
City	:	SEATTLE
State	:	WA
Zip	:	98112-3321
Country	:	US
Telephone Number	:	206-252-3407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2013
Last Update Date	:	03/07/2013

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