Wanta, Sandi

Wanta, Sandi is an individual health care provider with primary practice located at 506 4Th St , La Grande OR 97850-1906. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wanta, Sandi can be contacted via phone (541) 663-3138.

Contact Information

Primary practice address
506 4Th St La Grande OR 97850-1906
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 200850066 Oregon

Profile Details

NPI number 1770505778
LBN Legal business name Wanta, Sandi
Credentials RN, BSN
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Aug 14th, 2009 - about 15 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 1770505778 NPPES
Oregon MEDICAID 139449

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