Ckodre, Sandra Ann

Ckodre, Sandra Ann is an sole proprietor health care provider with primary practice located at 1275 2Nd Ave Sw , Tumwater WA 98512-6976. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Ckodre, Sandra Ann can be contacted via phone (360) 292-1182.

Contact Information

Primary practice address
1275 2Nd Ave Sw Tumwater WA 98512-6976
Fax: (360) 292-1184
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 100188 Washington
Behavioral Health & Social Service Providers / Mental Health 101YM0800X CG60150465 Washington

Profile Details

NPI number 1114447885
LBN Legal business name Ckodre, Sandra Ann
Credentials Bachelor of Arts (BA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2017
Last updated Jun 23rd, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114447885 NPPES
Washington MEDICAID 100188

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