MEDICARE: SANDI M SCOVEL D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH00002352	WA

General Provider Information

NPI Number	:	1023133634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDI M SCOVEL D.O.

Provider Business Mailing Address
First Line	:	621 BEACH AVE
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-4527
Country	:	US
Telephone Number	:	425-353-4314
Fax Number	:	425-514-0380

Provider Business Practice Location Address
First Line	:	621 BEACH AVE
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-4527
Country	:	US
Telephone Number	:	425-353-4314
Fax Number	:	425-514-0380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	02/24/2020

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