Provider Demographics
NPI:1356495568
Name:SAFFRAN, SANDRA K (ARNP, PHD, PC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:K
Last Name:SAFFRAN
Suffix:
Gender:F
Credentials:ARNP, PHD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 TIETON DR
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3477
Mailing Address - Country:US
Mailing Address - Phone:509-452-2404
Mailing Address - Fax:509-452-2409
Practice Address - Street 1:4601 TIETON DR
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3477
Practice Address - Country:US
Practice Address - Phone:509-452-2404
Practice Address - Fax:509-452-2409
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005001163WP0808X, 2084P0800X
WARN00059138163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8851550OtherMEDICARE GROUP PIN
WAG8851550OtherMEDICARE GROUP PIN
WAP57883Medicare UPIN