Most Relevant Information
Provider Data
| NPI Number: | 1003391723 |
| Provider Name: | IVAR SANDSMARK CDPT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | CO60696848 |
Most Important Dates
| Enumeration Date: | 09/27/2018 |
| Last Updated: | 09/27/2018 |
Provider Practice Location
11000 LAKE CITY WAY NE OFC
SEATTLE
WA
981256748
Practice Location Phone/Fax
| Phone: | 2064613614 |
| Fax: |
Provider Mailing Location
11000 LAKE CITY WAY NE OFC
SEATTLE
WA
981256748
Provider Mailing Phone/Fax
| Phone: | 2064613614 |
| Fax: |