OrganizationActive
Sacred Life LLC
NPI 1962093641 · Registered Nurse · Vancouver, WA
Provider details
- NPI number
- 1962093641
- Entity type
- Organization
- Primary specialty
- Registered NurseNursing Service Providers
- Organization subpart
- No
- Authorized official
- Ivan Sobovoy, Owner(360) 721-4303
Specialties & taxonomies
Nursing Service Providers
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11412 Ne 50th Ave
Vancouver, WA 98686-4418
Phone: (360) 699-6411
Street-level locationGet directions
Mailing address
11412 Ne 50th Ave
Vancouver, WA 98686-4418
Registry dates
- Enumerated
- 2021-01-27
- Last updated
- 2021-01-27
- Certified
- 2021-01-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.