Provider Demographics
NPI:1679712392
Name:SINATRA, DREW (NMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:
Last Name:SINATRA
Suffix:
Gender:M
Credentials:NMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 514
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-0514
Mailing Address - Country:US
Mailing Address - Phone:415-737-5550
Mailing Address - Fax:415-741-5786
Practice Address - Street 1:125 THROCKMORTON AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1909
Practice Address - Country:US
Practice Address - Phone:415-388-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNMD-0054175F00000X
WANT 60048749175F00000X
CA672175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath