Individual
BARRY VAUGHN SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
160 NW GILMAN BLVD STE 240, ISSAQUAH, WA 98027-2550
(425) 606-1359
(425) 642-8290
Mailing address
160 NW GILMAN BLVD STE 240, ISSAQUAH, WA 98027-2550
(425) 606-1359
(425) 642-8290
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
31864
AZ
207W00000X
Ophthalmology Physician
Primary
MD00048106
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806458
—
AZ
01
—
A20739210
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
12/29/2006
Last updated
08/26/2020
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