Provider Demographics
NPI:1356692545
Name:SHEELER, SINDIE LOU (DN60313524)
Entity type:Individual
Prefix:
First Name:SINDIE
Middle Name:LOU
Last Name:SHEELER
Suffix:
Gender:F
Credentials:DN60313524
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 W WASHINGTON ST
Mailing Address - Street 2:SUITE E-106
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3264
Mailing Address - Country:US
Mailing Address - Phone:360-681-7999
Mailing Address - Fax:360-582-9888
Practice Address - Street 1:680 W WASHINGTON ST
Practice Address - Street 2:SUITE E-106
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3264
Practice Address - Country:US
Practice Address - Phone:360-681-7999
Practice Address - Fax:360-582-9888
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADN60313524126900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126900000XDental ProvidersDental Laboratory Technician