MEDICARE: SANDIA Y BREKKE MD

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
1	207V00000X	Obstetrics & Gynecology Physician	27361	AZ
2	207VG0400X	Gynecology Physician	CP297	NE
3	207VG0400X	Gynecology Physician	221602	AK
4	207V00000X	Obstetrics & Gynecology Physician	52076	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538159587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDIA Y BREKKE MD

Provider Business Mailing Address
First Line	:	11335 NE 122ND WAY
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98034-6933
Country	:	US
Telephone Number	:	206-895-4292
Fax Number	:

Provider Business Practice Location Address
First Line	:	828 HEALTHY WAY STE 330
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-7959
Country	:	US
Telephone Number	:	206-895-4249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	03/17/2025

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Directions to “ SANDIA Y BREKKE MD” Practice Location

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