Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP60480604 | WA |
NPI | 1023410263 |
---|---|
Provider Name | Sandra Fisher |
First Address | Seattle, WA 98105-3820 |
Second Address | Seattle, WA 98105-2262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2014 |
Last Update Date | 18/09/2014 |