Provider Demographics
NPI:1811778772
Name:SANCHEZ, SIERRA ROSE (LPN)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:ROSE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:ROSE
Other - Last Name:RAMBOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:22123 50TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-6021
Mailing Address - Country:US
Mailing Address - Phone:253-576-9565
Mailing Address - Fax:
Practice Address - Street 1:6700 MARTIN WAY E
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-6502
Practice Address - Country:US
Practice Address - Phone:425-264-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP6089710164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse