Individual
MARIVEL SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
803 E LINCOLN AVE, SUNNYSIDE, WA 98944
(509) 837-3933
(809) 837-3885
Mailing address
2303 REITH WAY, PO BOX 119, SUNNYSIDE, WA 98944-9521
(509) 837-3933
(809) 837-3885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003955
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8325193
—
WA
Enumeration date
11/29/2006
Last updated
10/26/2016
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