Provider Demographics
NPI:1689866501
Name:WHITE, SANDRA L (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:L
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 34245
Mailing Address - Street 2:PSIP
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1245
Mailing Address - Country:US
Mailing Address - Phone:206-622-7747
Mailing Address - Fax:206-467-1470
Practice Address - Street 1:1001 SW KLICKITAT WAY STE 205
Practice Address - Street 2:PSIP
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-1161
Practice Address - Country:US
Practice Address - Phone:206-622-7747
Practice Address - Fax:206-467-1470
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60137845207ZP0102X
ORMD28492207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology