Sandra Elizabeth Davidson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60411383 Issued in WA

Practice address

18 NW 20TH Ave
Battle Ground, WA 98604-4175

Phone

(360) 597-9731

Fax

(360) 597-9732

NPI assigned

Dec 27, 2013

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

Other names 1

• Sandra Elizabeth Wirkkala Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10370/brand/1/csg/1/fhir/r4

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.

• Columbia River Mental Health Services

  dba Columbia River Associates

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vancouver, WA
  • NPI 1669411377
  Medicare reassignment
• Rose Medical Groups, PC

  dba Rose Urgent Care and Family Practice

  • Family Medicine Physician
  • Battle Ground, WA
  • NPI 1063818573
  NPD (past)

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1538580147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "address_2": "6926 N.E. FOURTH PLAIN BLVD.",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986661337",
            "telephone_number": "360-993-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 NW 20TH AVE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044175",
            "telephone_number": "360-597-9731",
            "fax_number": "360-597-9732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6926 NE Fourth Plain Blvd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986617369",
            "country_code": "US",
            "telephone_number": "360-993-3000 x3520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "SANDRA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-27",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60411383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "WIRKKALA",
            "middle_name": "ELIZABETH",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heidi Danforth, RN
• Daniel Chung DDS PLLC
• James Ray Darling, L.AC.
• Cathrine Arlene Darrow, LMT
• Sally Davidson
• Colleen Marie Davies, PA-C
• Anna Tien Davis
• Katherine De Bel, RN, IBCLC, CLC
• Amy E Delia, RPH
• Alexandra Katherine Demetro, ND, LM

• Clinical Social Worker in Battle Ground, WA
• Providers in Battle Ground, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.