Provider Demographics
NPI:1659848224
Name:SANDE, ESTELLA ANN (CMA)
Entity Type:Individual
Prefix:MRS
First Name:ESTELLA
Middle Name:ANN
Last Name:SANDE
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-6129
Mailing Address - Country:US
Mailing Address - Phone:360-457-0431
Mailing Address - Fax:509-457-5699
Practice Address - Street 1:118 E 8TH ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-6129
Practice Address - Country:US
Practice Address - Phone:360-457-0431
Practice Address - Fax:509-457-5699
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician