Provider Demographics
NPI:1730252552
Name:SANDIN, SHARON ANN (LMP)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ANN
Last Name:SANDIN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1521
Mailing Address - Street 2:209 MAIN AVE. SO. SUITE 102
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-1521
Mailing Address - Country:US
Mailing Address - Phone:425-831-5229
Mailing Address - Fax:425-831-0344
Practice Address - Street 1:209 MAIN AVE SO
Practice Address - Street 2:SUITE 102
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-1521
Practice Address - Country:US
Practice Address - Phone:425-831-5229
Practice Address - Fax:425-831-0344
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00005764174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist