Active NPI
Sandra Kalvoda Ritland, M.D.
- Family Medicine Physician
- Auburn, WA
National Provider Identifier
1104862309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00043953
- Practice address
- 17500 SE 392ND St
Auburn, WA 98092-9705 - Phone
- (253) 939-6648
- Fax
- (253) 735-6705
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00043953 | WA | Primary |
Addresses
Primary practice location
17500 SE 392ND St
Auburn, WA 98092-9705
Mailing address
17500 SE 392ND St
Auburn, WA 98092-9705
Phone (253) 939-6648
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2159RI | Other | WA | REGENCE BLUESHIELD INS |
| 5736RI | Other | WA | REGENCE/STECK |
| 0237234 | Other | WA | L&I/STECK |
| 5997RI | Other | WA | REGENCE BLUESHIELD INS |
| 8400921 | Medicaid | WA | |
| 5124RI | Other | WA | REGENCE BLUESHIELD INS |
| 8903810 | Other | WA | DEPT L&I, CRIME VICTIMS |
| 4215RI | Other | WA | REGENCE BLUESHIELD INS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Olympic Physicians P.L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Shelton, WA
- NPI 1417156183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1104862309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17500 SE 392ND ST",
"city": "AUBURN",
"state": "WA",
"postal_code": "980929705",
"telephone_number": "253-939-6648",
"fax_number": "253-735-6705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17500 SE 392ND ST",
"city": "AUBURN",
"state": "WA",
"postal_code": "980929705",
"telephone_number": "253-939-6648",
"fax_number": "253-735-6705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RITLAND",
"first_name": "SANDRA",
"middle_name": "KALVODA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00043953",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUESHIELD INS",
"identifier": "2159RI",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE/STECK",
"identifier": "5736RI",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I/STECK",
"identifier": "0237234",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUESHIELD INS",
"identifier": "5997RI",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8400921",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUESHIELD INS",
"identifier": "5124RI",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT L&I, CRIME VICTIMS",
"identifier": "8903810",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUESHIELD INS",
"identifier": "4215RI",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.