Healthcare Provider Details

I. General information

NPI: 1548983802
Provider Name (Legal Business Name): MRS. SANGU KANDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

BOX 357260 UNIVERSITY OF WASHINGTON
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 800-329-8387
  • Fax:
Mailing address:
  • Phone: 206-543-8736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP70018235
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: