Provider Demographics
NPI:1407195191
Name:SANDVICK, CARRIE L (ACSM HFS, NSCA CSCS)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:SANDVICK
Suffix:
Gender:F
Credentials:ACSM HFS, NSCA CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4162 148TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5164
Mailing Address - Country:US
Mailing Address - Phone:425-869-9506
Mailing Address - Fax:
Practice Address - Street 1:4162 148TH AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5164
Practice Address - Country:US
Practice Address - Phone:425-869-9506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner