Healthcare Provider Details

I. General information

NPI: 1467526244
Provider Name (Legal Business Name): STEVEN LYNN SANDIFER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 6TH AVE SE SUITE D
LACEY WA
98503-1041
US

IV. Provider business mailing address

4315 6TH AVE SE SUITE D
LACEY WA
98503-1041
US

V. Phone/Fax

Practice location:
  • Phone: 360-438-6559
  • Fax: 360-352-4202
Mailing address:
  • Phone: 360-438-6559
  • Fax: 360-352-4202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00002707
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberCH00002707
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: