Individual provider Active NPI

Gladys Sandana, LE, CME, COE, CPCP

  • Specialist
  • Tacoma, WA
National Provider Identifier
1295000651
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
602869350 Issued in WA
Practice address
1424 49TH St NE
Tacoma, WA 98422-1818
Phone
(253) 948-7127
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 602869350 WA Primary

Addresses

Primary practice location

1424 49TH St NE
Tacoma, WA 98422-1818

Mailing address

509 Valley Ave NE
#16
Puyallup, WA 98372-6965
Phone (253) 948-7127

Other identifiers 1

IdentifierTypeStateIssuer
602869350MedicaidWA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
602869350WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1295000651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 VALLEY AVE NE",
            "address_2": "#16",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983726965",
            "telephone_number": "253-948-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 49TH ST NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984221818",
            "telephone_number": "253-948-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDANA",
        "first_name": "GLADYS",
        "name_prefix": "Ms.",
        "credential": "LE, CME, COE, CPCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "602869350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "602869350",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.