Healthcare Provider Details

I. General information

NPI: 1538209820
Provider Name (Legal Business Name): SANDI L. BUZAR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12844 MILITARY RD S
TUKWILA WA
98168-3045
US

IV. Provider business mailing address

12844 MILITARY RD S
TUKWILA WA
98168-3045
US

V. Phone/Fax

Practice location:
  • Phone: 206-248-4500
  • Fax: 206-439-4697
Mailing address:
  • Phone: 206-248-4500
  • Fax: 206-439-4697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberRN00134600
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: