Provider Demographics
NPI:1508896879
Name:SANDERSON, AURA L (PA-C)
Entity Type:Individual
Prefix:
First Name:AURA
Middle Name:L
Last Name:SANDERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AURA
Other - Middle Name:L
Other - Last Name:TINSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:600 ORONDO AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2800
Mailing Address - Country:US
Mailing Address - Phone:509-662-6000
Mailing Address - Fax:
Practice Address - Street 1:105 S APPLE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816
Practice Address - Country:US
Practice Address - Phone:509-682-6000
Practice Address - Fax:509-682-6192
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004904363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1012093Medicaid
WA8441032Medicaid
WAQ59780Medicare UPIN