Individual
SANDRA BALLEW SIKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,BSN,MN WHCNP
Contact information
Practice address
3550 N INTERSTATE AVE, INTERSTATE MEDICAL OFFICE-EAST, PORTLAND, OR 97227-1196
(503) 331-6283
Mailing address
3550 N INTERSTATE AVE, INTERSTATE MEDICAL OFFICE-EAST, PORTLAND, OR 97227-1196
(503) 331-6283
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
430476
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
200550065NP
OR
363LW0102X
Women's Health Nurse Practitioner
NP9709
CA
Other
Enumeration date
09/24/2006
Last updated
06/28/2008
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