Provider Demographics
NPI:1104255785
Name:MILES, SARAH VIRGINIA (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:VIRGINIA
Last Name:MILES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W
Mailing Address - Street 2:STE 210
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:253-301-5100
Mailing Address - Fax:
Practice Address - Street 1:12040 NE 128TH ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3013
Practice Address - Country:US
Practice Address - Phone:425-899-1800
Practice Address - Fax:425-899-1804
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60448342363AM0700X, 363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0442216OtherL & I - SWEDISH RADIA
WA0442190OtherL & I - RADIA
WA0442225OtherL & I - SOUTH SOUND RADIOLOGY
WA0442192OtherL & I - RADIA
WA0442230OtherL & I - VANCOUVER RADIOLOGISTS
WA0442216OtherL & I - EVERGREEN RADIA
WA0442228OtherL & I - SEATTLE RADIOLOGY
WA2035102Medicaid