1295971364 NPI number — DR. CONSTANCE J SANCHEZ ND

Table of content: DR. CONSTANCE J SANCHEZ ND (NPI 1295971364)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295971364 NPI number — DR. CONSTANCE J SANCHEZ ND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANCHEZ
Provider First Name:
CONSTANCE
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ND
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SANCHEZ
Provider Other First Name:
CONNIE
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ND
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1295971364
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2136 S 260TH ST APT CC201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98198-9088
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-973-9596
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15215 SE 272ND ST STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98042-9918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-395-7542
Provider Business Practice Location Address Fax Number:
425-657-9834
Provider Enumeration Date:
12/19/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 175F00000X , with the licence number:  NT00001396 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)