Individual provider Active NPI

Sharon Ann Sandin, LMP

  • Specialist
  • North Bend, WA
National Provider Identifier
1730252552
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00005764 Issued in WA
Practice address
209 Main Ave So
Suite 102
North Bend, WA 98045-1521
Phone
(425) 831-5229
Fax
(425) 831-0344
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00005764 WA Primary

Addresses

Primary practice location

209 Main Ave So
Suite 102
North Bend, WA 98045-1521

Mailing address

PO Box 1521
209 Main Ave. So. Suite 102
North Bend, WA 98045-1521
Phone (425) 831-5229

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
MA00005764WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730252552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1521",
            "address_2": "209 MAIN AVE. SO. SUITE 102",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980451521",
            "telephone_number": "425-831-5229",
            "fax_number": "425-831-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MAIN AVE SO",
            "address_2": "SUITE 102",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980451521",
            "telephone_number": "425-831-5229",
            "fax_number": "425-831-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIN",
        "first_name": "SHARON",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00005764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.