Healthcare Provider Details

I. General information

NPI: 1437860012
Provider Name (Legal Business Name): SANDRA OKAFOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4526 FEDERAL AVE BLDG 1
EVERETT WA
98203-2132
US

IV. Provider business mailing address

4526 FEDERAL AVE BLDG 1
EVERETT WA
98203-2132
US

V. Phone/Fax

Practice location:
  • Phone: 240-917-7922
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: