Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 6315 | KS |
Y | 208800000X | Urologist | MD60152962 | WA |
NPI | 1003937947 |
---|---|
Provider Name | Dr. Sandra Jane Hadjinian |
First Address | Mount Vernon, WA 98274-4127 |
Second Address | Mount Vernon, WA 98274-4127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 16/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2008756 | (05) | WA |