Debra Sue Sandvig, RD,CD, IBCLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

818154 Issued in WA

Practice address

507 N Nanum St
Suite 102
Ellensburg, WA 98926-2886

Phone

(509) 962-7515

Fax

(509) 962-7581

NPI assigned

May 21, 2008

Last updated

May 21, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kittitas County Public Health

  • State or Local Public Health Clinic/Center
  • Ellensburg, WA
  • NPI 1508924275
  NPD (past)

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1316104896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N NANUM ST",
            "address_2": "SUITE 102",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989262886",
            "telephone_number": "509-962-7515",
            "fax_number": "509-962-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N NANUM ST",
            "address_2": "SUITE 102",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989262886",
            "telephone_number": "509-962-7515",
            "fax_number": "509-962-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDVIG",
        "first_name": "DEBRA",
        "middle_name": "SUE",
        "name_prefix": "Mr.",
        "credential": "RD,CD, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "818154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Salvati, RN
• Polly Sams, LICSW
• John H Sand, M.D.
• Sara Ariana Sandalow, RN
• Itzel Guadalupe Sandoval Manzo, DPT
• Jillian Santi
• Lizette Santos Guijarro
• Kojo Sarfo
• Adrian Francis Sarita, M.D.
• Dominic James Sarria-Wiley, PHARM.D

• Registered Dietitian in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.