Individual provider Active NPI

Sandra Dawson Canaday, ARNP

  • Nurse Practitioner
  • Lakewood, WA
National Provider Identifier
1114236783
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60181508 Issued in WA
Practice address
4909 108TH St SW
Lakewood, WA 98499-3724
Phone
(253) 581-3075
Fax
(253) 581-3178
NPI assigned
Sep 30, 2010
Last updated
Oct 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60181508 WA Primary

Addresses

Primary practice location

4909 108TH St SW
Lakewood, WA 98499-3724

Mailing address

PO Box 98886
Lakewood, WA 98496-8886
Phone (253) 584-3577

Other names 1

  • Sandra Arevalo Dawson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110105000099 WA Practitioner - Nurse Practitioner 4789873860 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Olympic Peninsula Health ServicesGroup PAC ID 9830524966, 3 clinicians

Practice addresses (Care Compare)

150 Chimacum Rd
Unit a
Port Hadlock, WA 98339-9774
Phone (360) 912-5777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60181508WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Integrated Health LLC CurrentSince Jan 1, 2019 Accepting new patients
Olympic Peninsula Health Services CurrentSince Nov 1, 2025 Accepting new patients
Seattle Pain Center Medical Corporation Past Accepting new patients
Adult Inpatient Medical Services,PLLC Past Accepting new patients

Locations

1106 E 1st St
Port Angeles, WA 98362
Phone (360) 452-2954

150 Chimacum Rd
Unit A
Port Hadlock, WA 98339

661 Ness Corner Rd
Port Hadlock, WA 98339
Phone (360) 912-5777

3640 S Cedar St
Ste M
Tacoma, WA 98409
Phone (253) 426-8666

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1114236783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98886",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984968886",
            "telephone_number": "253-584-3577",
            "fax_number": "253-584-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 108TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993724",
            "telephone_number": "253-581-3075",
            "fax_number": "253-581-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADAY",
        "first_name": "SANDRA",
        "middle_name": "DAWSON",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60181508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "DAWSON",
            "middle_name": "AREVALO",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.