Provider Demographics
NPI:1669288312
Name:SANDER, KESSLYN GRACE ELSYON MARTHA (CPM)
Entity type:Individual
Prefix:
First Name:KESSLYN
Middle Name:GRACE ELSYON MARTHA
Last Name:SANDER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:KESSLYN
Other - Middle Name:GRACE ELSYON MARTHA
Other - Last Name:FLECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPM
Mailing Address - Street 1:4217 N HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-1339
Mailing Address - Country:US
Mailing Address - Phone:509-993-1884
Mailing Address - Fax:
Practice Address - Street 1:4217 N HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-1339
Practice Address - Country:US
Practice Address - Phone:509-993-1884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-07
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No171400000XOther Service ProvidersHealth & Wellness Coach
No374J00000XNursing Service Related ProvidersDoula