Provider Demographics
NPI:1780646885
Name:SCHABLE, SANDRA KAY (DC)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KAY
Last Name:SCHABLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-5824
Mailing Address - Country:US
Mailing Address - Phone:360-733-1660
Mailing Address - Fax:360-733-1182
Practice Address - Street 1:2200 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-5824
Practice Address - Country:US
Practice Address - Phone:360-733-1660
Practice Address - Fax:360-733-1182
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2028041Medicaid
WAU92068Medicare UPIN
WAGAB29192Medicare ID - Type Unspecified