Provider Demographics
NPI:1063699494
Name:SARTIN, SALLY HAE-RYUN (MD)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:HAE-RYUN
Last Name:SARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 897
Mailing Address - Street 2:
Mailing Address - City:KETTLE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:99141-0897
Mailing Address - Country:US
Mailing Address - Phone:737-307-1026
Mailing Address - Fax:
Practice Address - Street 1:2048 RICKEY CANYON RD
Practice Address - Street 2:
Practice Address - City:RICE
Practice Address - State:WA
Practice Address - Zip Code:99167-9753
Practice Address - Country:US
Practice Address - Phone:737-307-1026
Practice Address - Fax:855-844-1029
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60396757207Q00000X
CAA105915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine