# SANDRA L BIRDLEBOUGH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1578644852
- **Gender:** F
- **Credential:** PHD, ARNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | PY00002504 | WA | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AP30005617 | WA | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 07/31/2009