Provider Demographics
NPI:1942257027
Name:SANDRI, PIERO FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:PIERO
Middle Name:FRANCIS
Last Name:SANDRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10334 NE BEACH CREST DR
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1390
Mailing Address - Country:US
Mailing Address - Phone:206-842-8262
Mailing Address - Fax:
Practice Address - Street 1:32014 LITTLE BOSTON RD NE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:WA
Practice Address - Zip Code:98346-9734
Practice Address - Country:US
Practice Address - Phone:360-297-2840
Practice Address - Fax:360-297-7052
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00019655174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA910875163-43OtherKPS ID#
WA0175647OtherL&I ID#
WA5163PIOtherREGENCE RIDER#
WA1003243Medicaid
WAA07066Medicare UPIN
WA1003243Medicaid