Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CH00002707 | WA |
N | 111NR0200X | Radiology | CH00002707 | WA |
N | 213ER0200X | Radiology | CH00002707 | WA |
NPI | 1467526244 |
---|---|
Provider Name | Dr. Steven Lynn Sandifer |
First Address | Lacey, WA 98503-1041 |
Second Address | Lacey, WA 98503-1041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105675 | LABOR AND INDUSTRIES (01) | WA |