Provider Demographics
NPI:1992817225
Name:ARDREN, SARA SARTORIUS (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:SARTORIUS
Last Name:ARDREN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:SUE
Other - Last Name:SARTORIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 W PINE CT
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-5188
Mailing Address - Country:US
Mailing Address - Phone:360-425-7741
Mailing Address - Fax:
Practice Address - Street 1:1230 7TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3166
Practice Address - Country:US
Practice Address - Phone:360-636-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004518363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant