Derenge, Sara

Derenge, Sara is an individual health care provider with primary practice located at 1057 12Th Ave , Longview WA 98632-2509. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Derenge, Sara can be contacted via phone (360) 636-3892.

Contact Information

Primary practice address
1057 12Th Ave Longview WA 98632-2509
Phone: (360) 636-3892
Fax: (360) 414-1114
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X RN00142323 Washington
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X AP30005950 Washington

Profile Details

NPI number 1053326934
LBN Legal business name Derenge, Sara
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2006
Last updated Nov 23rd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053326934 NPPES
Washington MEDICAID 9632449

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