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Individual

SANDRA MARIAN LORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
23213 PACIFIC HWY S, KENT, WA 98032-2721
(206) 870-8880
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00036786
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0169439
L&I
05
1306921119
WA
01
160010
INTERNAL ID-MOTOR VEHICLE ID
Enumeration date
10/27/2006
Last updated
08/21/2012
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