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NPI Code Detail

MEDICARE: DR. SANDRA B KALNINS D.O.

MEDICARE: DR. SANDRA B KALNINS 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
12084P0800XPsychiatry PhysicianOP00001518WA
22084P0800XPsychiatry PhysicianV2891TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
136903OTHERMNMEDICAL LICENSE

General Provider Information

NPI Number : 1710954573
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANDRA B KALNINS D.O.
Provider Business Mailing Address
First Line : 4526 FEDERAL AVE
Second Line :
City : EVERETT
State : WA
Zip : 98203-2132
Country : US
Telephone Number : 425-349-6200
Fax Number :
Provider Business Practice Location Address
First Line : 4526 FEDERAL AVE
Second Line :
City : EVERETT
State : WA
Zip : 98203-2132
Country : US
Telephone Number : 425-349-6200
Fax Number : 360-419-3505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 12/12/2024

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