# SAND PLASTIC SURGERY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306518113
- **Authorized official:** DR. JORDAN P SAND MD (MANAGING DIRECTOR)
- **Authorized official phone:** (095) 324-2980

## Contact information

- **Practice address:** 307 W 6TH AVE STE 200, SPOKANE, WA 99204-2502
- **Practice address phone:** (509) 324-2980
- **Mailing address:** 307 W 6TH AVE STE 200, SPOKANE, WA 99204-2502
- **Mailing address phone:** (095) 324-2980
- **Mailing address fax:** (509) 418-9462

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YS0123X | Facial Plastic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/30/2021
- **Last updated:** 10/06/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2201492 | — | WA |