Individual
SALLY YEAROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13501 NE 28TH ST, VANCOUVER, WA 98682-8091
(360) 604-6704
Mailing address
13501 NE 28TH ST, VANCOUVER, WA 98682-8091
(360) 604-6704
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN00116338
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245311141
—
WA
Enumeration date
03/26/2019
Last updated
03/26/2019
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