Basic Information
| Provider Information | |||||||||
| NPI: | 1700136371 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARSYLA | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | REGISTERED NURSE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 135 W MAIN ST | ||||||||
| Address2: | P. O BOX 1445 | ||||||||
| City: | CHEHALIS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985324817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607486696 | ||||||||
| FaxNumber: | 3607480627 | ||||||||
| Practice Location | |||||||||
| Address1: | 135 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CHEHALIS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985324817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607486696 | ||||||||
| FaxNumber: | 3607480627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2012 | ||||||||
| LastUpdateDate: | 09/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN60195071 | WA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.