Individual
SANDRA CAROLLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
402 S 4TH AVE, YAKIMA, WA 98902-3546
(509) 575-4084
Mailing address
PO BOX 959, YAKIMA, WA 98907-0959
(509) 575-4084
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30004738
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123346
L & I
WA
01
—
18214
GROUP HEALTH
—
01
—
911019392
COMMERCIAL
—
01
—
9392CA
REGENCE
WA
01
—
9622333
CHPW
WA
05
—
9622333
—
WA
Enumeration date
10/03/2006
Last updated
07/21/2011
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