Sandra M Dickey, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10004027 Issued in WA

Practice address

1215 N McDonald Rd
202
Spokane Valley, WA 99216-1557

Phone

(509) 455-8820

Fax

(509) 838-4978

NPI assigned

Nov 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Health & Services-Wa

  dba NW Heart & Lung Surgical Assoc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Spokane, WA
  • NPI 1538311287
  NPD (past)
• Wa Spok DH Crna LLC

  • Certified Registered Nurse Anesthetist
  • Spokane, WA
  • NPI 1366692766

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1023188182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W 7TH AVE",
            "address_2": "450",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042349",
            "telephone_number": "509-455-8820",
            "fax_number": "509-838-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N MCDONALD RD",
            "address_2": "202",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161557",
            "telephone_number": "509-455-8820",
            "fax_number": "509-838-4978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 W 7th Ave Ste 450",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042321",
            "country_code": "US",
            "telephone_number": "509-455-8820",
            "fax_number": "509-838-4978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16528 E Desmet Ct Ste 32003200",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992163522",
            "country_code": "US",
            "telephone_number": "509-922-0136",
            "fax_number": "509-838-4978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806428300",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8331274",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdickey220149@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "62 W 7th Ave Ste 450",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdickey220149@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16528 E Desmet Ct Ste 32003200",
            "city": "Spokane Valley",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992163522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Renee Diaz
• Shannon G Dibartolo, PHARMD
• Timothy Daniel Dibble, MD
• Shannon M Dickens, MSW
• Alexus Jamelia Dickerson
• Amanda Lin Dickinson
• Deanna Nichole Dickson
• Louis Diconti, BA
• Thomas M Diimmel, ATC
• Nathan Craig Dikes, DPM

• Physician Assistant in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.