Healthcare Provider Details

I. General information

NPI: 1689666927
Provider Name (Legal Business Name): SANDRA A HORVATH-DORI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 09/15/2021
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6710 W OKANOGAN PL
KENNEWICK WA
99336-8001
US

IV. Provider business mailing address

256 WINDOW ROCK CT
GRAND JUNCTION CO
81507-1165
US

V. Phone/Fax

Practice location:
  • Phone: 509-942-2528
  • Fax: 509-942-2544
Mailing address:
  • Phone: 970-208-4784
  • Fax: 970-298-5905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number37962
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number85146
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number61187446
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: