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NPI Code Detail

MEDICARE: SANDRA EHRHART RD, CD

MEDICARE:   SANDRA  EHRHART  RD, CD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian940930WA

General Provider Information

NPI Number : 1356481741
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA EHRHART RD, CD
Provider Business Mailing Address
First Line : PO BOX 34703
Second Line :
City : SEATTLE
State : WA
Zip : 98124-1703
Country : US
Telephone Number : 206-764-0112
Fax Number : 206-764-0489
Provider Business Practice Location Address
First Line : 8915 14TH AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98108-4813
Country : US
Telephone Number : 206-762-0876
Fax Number : 206-763-1856
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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Directions to “ SANDRA EHRHART RD, CD” Practice Location

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