Provider Demographics
NPI:1821753328
Name:SALTZER, SANDRA LOUISE
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LOUISE
Last Name:SALTZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HAUSMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97327-2157
Mailing Address - Country:US
Mailing Address - Phone:206-552-1904
Mailing Address - Fax:
Practice Address - Street 1:100 HAUSMAN AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:OR
Practice Address - Zip Code:97327-2157
Practice Address - Country:US
Practice Address - Phone:206-552-1904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR095006196163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health