Provider Demographics
NPI:1417593401
Name:ZEILSTRA, SANDRA
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:ZEILSTRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 NE 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-5926
Mailing Address - Country:US
Mailing Address - Phone:206-201-1613
Mailing Address - Fax:
Practice Address - Street 1:PARROT TREE RESORT
Practice Address - Street 2:
Practice Address - City:ROIATAN
Practice Address - State:BAY ISLANDS
Practice Address - Zip Code:000000
Practice Address - Country:HN
Practice Address - Phone:206-201-1613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program