Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD00029813 | WA |
N | 111NI0900X | Internist | MD00029813 | WA |
Y | 207RH0002X | Hospice and Palliative Medicine | MD00029813 | WA |
NPI | 1144269572 |
---|---|
Provider Name | Sandford Plant |
First Address | Vancouver, WA 98664-1913 |
Second Address | Vancouver, WA 98664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 05/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8138778 | (05) | WA |