Sandra Breaux

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH0041531 Issued in WA

Practice address

8924 Quil Ceda Blvd
Tulalip, WA 98271

Phone

(360) 657-1223

Fax

(360) 657-5233

NPI assigned

Jul 28, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1710395355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7523 NE 203RD ST",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980282078",
            "telephone_number": "206-310-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8924 QUIL CEDA BLVD",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "98271",
            "telephone_number": "360-657-1223",
            "fax_number": "360-657-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAUX",
        "first_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH0041531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4928884",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568489698",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6024533",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beda Chelh
• Rebecca Lynne Berry, RN
• Marlyce Black, LMP
• Cinda Jo Bolette
• Tory L Booth, MA, LMFT, ATR
• Brooke Kathryn Burkett, LMP
• Ashley Monique Burress, PHARMD
• Caring Hands Home Health Care
• Suk Choo Chang, MD
• Marie L. Cross, C.D.P.

• Pharmacist in Tulalip, WA
• Providers in Tulalip, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.