Provider Demographics
NPI:1528510898
Name:SAIRO, TITUS KOIPATON (FNP-C)
Entity type:Individual
Prefix:MR
First Name:TITUS
Middle Name:KOIPATON
Last Name:SAIRO
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 BOULEVARD NE STE 310
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1264
Mailing Address - Country:US
Mailing Address - Phone:678-371-8222
Mailing Address - Fax:
Practice Address - Street 1:1201 PACIFIC AVE STE 400
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4381
Practice Address - Country:US
Practice Address - Phone:253-300-8453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131522363LF0000X
GARN188920363LF0000X
WA61004280363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily