Healthcare Provider Details

I. General information

NPI: 1013206283
Provider Name (Legal Business Name): VIRGINIA EILEEN SANDERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2011
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE # M1-13
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE # M1-13
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-8232
  • Fax: 206-985-3201
Mailing address:
  • Phone:
  • Fax: 206-985-3201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 60467942
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: