# SIDRA HEALTHCARE LLC

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

## Provider details

- **NPI number:** 1588343255
- **Authorized official:** UBAH GAANI NP (SOLE MEMBER)
- **Authorized official phone:** (253) 642-4104

## Contact information

- **Practice address:** 4219 S OTHELLO ST \# 105F, SEATTLE, WA 98118-3892
- **Practice address phone:** (206) 910-0667
- **Practice address fax:** (206) 673-8050
- **Mailing address:** 4219 S OTHELLO ST \# 105F, SEATTLE, WA 98118-3892
- **Mailing address fax:** (206) 673-8050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/11/2023
- **Last updated:** 07/11/2023