Healthcare Provider Details

I. General information

NPI: 1235240193
Provider Name (Legal Business Name): ERIN ANNE SANDERSON R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 VETERANS DR SW
TACOMA WA
98493-5000
US

IV. Provider business mailing address

12714 117TH STREET CT E
PUYALLUP WA
98374-5063
US

V. Phone/Fax

Practice location:
  • Phone: 253-583-1117
  • Fax: 253-589-4150
Mailing address:
  • Phone: 253-770-8984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00120721
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: