Provider Demographics
NPI:1376606699
Name:CHRISTENSEN, SANDRA M (ARNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:M
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18720 81ST AVE W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026
Mailing Address - Country:US
Mailing Address - Phone:206-229-2764
Mailing Address - Fax:206-294-4946
Practice Address - Street 1:2611 NE 125TH ST
Practice Address - Street 2:SUITE 100B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:206-229-2764
Practice Address - Fax:206-294-4946
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006297363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner