Sandra Van Kirk
Individual provider Active NPI Licensed Practical Nurse · Orting, WA
NPI 1306398169 · NPPES record last updated Oct 27, 2016
Key facts
- NPI
- 1306398169
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LP00043021 (WA)
- Practice address
- 121 Whitesell St NE
Orting, WA 98360-8410 - Phone
- (360) 893-6500
- Fax
- (360) 893-4367
- NPI assigned
- Oct 27, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP00043021 | WA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP00043021 | WA | Yes |
Addresses
Primary practice location
121 Whitesell St NE
Orting, WA 98360-8410
Mailing address
121 Whitesell St NE
Orting, WA 98360-8410
Phone (360) 893-6500
NPI Registry JSON
{
"created_epoch": "1477526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477526400000",
"number": "1306398169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 WHITESELL ST NE",
"city": "ORTING",
"state": "WA",
"postal_code": "983608410",
"telephone_number": "360-893-6500",
"fax_number": "360-893-4367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 WHITESELL ST NE",
"city": "ORTING",
"state": "WA",
"postal_code": "983608410",
"telephone_number": "360-893-6500",
"fax_number": "360-893-4367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN KIRK",
"first_name": "SANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-27",
"last_updated": "2016-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WA",
"license": "LP00043021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orting, WA
- Bridget Thompson
- Tierra Ashcroft Tierra Ashcroft
- Fatima Viridiana Torres
- Hieu Tran
- Tranquil Minds PLLC
- Erika Paola Vergara-Lopez
- Kathleen A Villyard
- Nicole Lynn Ward
- Westcare Washington, Inc
- Sarah Amanda Wilson
All providers in Orting, WA · Licensed Practical Nurse in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.