Sandra Ellen Needham, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP30003007 Issued in WA

Practice address

3025 Oakes Ave
Everett, WA 98201-3657

Phone

(425) 388-3609

Fax

(425) 388-3526

NPI assigned

May 14, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780899492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5396 LANGLEY RD",
            "city": "LANGLEY",
            "state": "WA",
            "postal_code": "982609558",
            "telephone_number": "360-221-5041",
            "fax_number": "425-388-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 OAKES AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013657",
            "telephone_number": "425-388-3609",
            "fax_number": "425-388-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEEDHAM",
        "first_name": "SANDRA",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP30003007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9608829",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Everett, WA
• Providers in Everett, WA by specialty
• Adult Health Nurse Practitioner in Washington

• 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.