Healthcare Provider Details

I. General information

NPI: 1447227921
Provider Name (Legal Business Name): SANDRA PERLMUTTER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA JOHNSON ARNP

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 06/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 7TH AVE FL 7 SUITE 400
SEATTLE WA
98104-1132
US

IV. Provider business mailing address

550 17TH AVE SUITE 400
SEATTLE WA
98122-5788
US

V. Phone/Fax

Practice location:
  • Phone: 206-860-2302
  • Fax:
Mailing address:
  • Phone: 206-860-2302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30006307
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: