SALLY L CONRAD (NPI# 1770812851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770812851 |
| Entity Type | Individual |
| Full Name | SALLY L CONRAD |
| Credential | PA-C |
| Practice Address |
20730 Bond Rd Ne Ste 205 Poulsbo WA 98370-9000 |
| Mailing Address |
8884 Selbo Peak Pl Nw Bremerton WA 98311-9456 |
| Practice Telephone | 3607799727 |
| Mailing Telephone | 3605092612 |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2016-11-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10003503 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
20730 BOND RD NE STE 205 |
| City | POULSBO |
| State | WA |
| Zip Code | 98370-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659397701 | Donald Warren Novey | Family Medicine | 20730 Bond Rd Ne Ste 205, Poulsbo, WA 98370-9000 | 2006-07-14 |
| 1295073815 | Nicole R. Writer | Physician Assistant | 20730 Bond Rd Ne Ste 205, Poulsbo, WA 98370-9000 | 2013-01-17 |
| 1447304449 | North Kitsap Family Practice and Urgent Care P.s. | Family Medicine | 20730 Bond Rd Ne Ste 205, Poulsbo, WA 98370-9000 | 2007-01-23 |
| 1144305186 | Roger L Cox | Physician Assistant | 20730 Bond Rd Ne Ste 205, Poulsbo, WA 98370-9000 | 2006-10-26 |
| 1679658678 | James A Van | Physician Assistant | 20730 Bond Rd Ne Ste 205, Poulsbo, WA 98370-9000 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790324010 | Francie Corinn Edens | Massage Therapist | 225 Nw Lindvig Way Suite# 6, Poulsbo, WA 98370 | 2020-01-03 |
| 1972155679 | Marcela Serocki | Massage Therapist | 18657 Wa-305, Suite 4, Poulsbo, WA 98370 | 2019-07-12 |
| 1508425943 | Ryan Brinton | Physical Therapist | Kitsap Physical Therapy and Sports Clinics, 19319 7th Ave Ne Ste 108, Poulsbo, WA 98370 | 2019-06-10 |
| 1598220816 | Naomi Whitney Orong | Massage Therapist | 19068 Nw Jenson Way, Suite 4b, Poulsbo, WA 98370 | 2019-02-01 |
| 1043774953 | Maryanne Phillips Bellman | Physical Therapist | 442 Viewmont Ave, Poulsbo, WA 98370 | 2019-01-24 |
| 1285102293 | Andrea Sander | Registered Nurse | 19883 12th Ave Ne, Poulsbo, WA 98370 | 2018-11-07 |
| 1376038281 | Sharon Renay Christor | Nurse Practitioner | 19160 Front St. Ne, Poulsbo, WA 98370 | 2018-06-25 |
| 1700304334 | Samantha Przybylek Gavinski | Nurse Practitioner | 19500 10th Ave Ne Suite 100, Poulsbo, WA 98370 | 2017-09-04 |
| 1285164327 | Johanna Taylor | Behavior Technician | 21786 Windmill Loop Nw, Poulsbo, WA 98370 | 2017-06-12 |
| 1568990554 | Eva Geurtsen | Physical Therapy Assistant | 19160 Front St, Poulsbo, WA 98370 | 2017-06-02 |
| Find all providers in zip 98370 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386736528 | Greg W Mennie | Physician Assistant | 10362 Capistrano Pl Ne, Poulsbo, WA 98370-6924 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735618 | Gavin Guard | Physician Assistant | 818 Mullis St Ste 6, Friday Harbor, WA 98250-7986 | 2020-06-19 |
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1841791274 | Sjs, Pllc | Physician Assistant | 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 | 2018-02-21 |
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1194251983 | Christopher Joseph Stanley | Physician Assistant | 1010 Ne Lilac St Apt 301, Issaquah, WA 98029-7878 | 2017-05-11 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1801344601 | Jessica Ann Pettitt | Physician Assistant | 21200 Ne 190th Ct, Battle Ground, WA 98604-9636 | 2016-09-21 |
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SALLY L CONRAD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.