MEDICARE: SONJA SIVESIND

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	171100000X	Acupuncturist	60069722	WA

General Provider Information

NPI Number	:	1902151632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONJA SIVESIND

Provider Business Mailing Address
First Line	:	3811 S FERDINAND ST APT B
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1759
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3811 S FERDINAND ST APT B
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1759
Country	:	US
Telephone Number	:	206-760-6064
Fax Number	:

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

Provider Enumeration Date	:	07/18/2012
Last Update Date	:	07/18/2012

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Directions to “ SONJA SIVESIND ” Practice Location

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