Provider Demographics
NPI:1306226840
Name:SANCHEZ, DAWNA A (RD, CDE)
Entity Type:Individual
Prefix:
First Name:DAWNA
Middle Name:A
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2330
Mailing Address - Country:US
Mailing Address - Phone:360-358-3551
Mailing Address - Fax:
Practice Address - Street 1:4220 HOYT AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2317
Practice Address - Country:US
Practice Address - Phone:425-258-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR687821133V00000X
WADI60717136133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB254170Medicare PIN