Individual provider Active NPI

Sally Yearout

  • School Registered Nurse
  • Vancouver, WA
National Provider Identifier
1154882942
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN00116338 Issued in WA
Practice address
13501 NE 28TH St
Vancouver, WA 98682-8091
Phone
(360) 604-6704
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN00116338 WA Primary

Addresses

Primary practice location

13501 NE 28TH St
Vancouver, WA 98682-8091

Mailing address

13501 NE 28TH St
Vancouver, WA 98682-8091
Phone (360) 604-6704

Other identifiers 1

IdentifierTypeStateIssuer
1245311141MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Vancouver

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN00116338WAMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1154882942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13501 NE 28TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986828091",
            "telephone_number": "360-604-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 NE 28TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986828091",
            "telephone_number": "360-604-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAROUT",
        "first_name": "SALLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WA",
            "license": "RN00116338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245311141",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Vancouver",
            "affiliation": "N",
            "address_1": "13501 NE 28th St",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986828091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.