Individual
SANDRA D PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DH
Contact information
Practice address
800 WEST MAPLE STREET, MEDICAL LAKE, WA 99022-0800
(509) 565-4000
(509) 565-7015
Mailing address
P O BOX 800, 800 WEST MAPLE STREET, MEDICAL LAKE, WA 99022-0800
(509) 565-4000
(509) 565-7015
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00007167
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH00007167
DENTAL HYGIENE LICENSE
WA
Enumeration date
01/20/2010
Last updated
01/20/2010
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