Basic Information
Provider Information
NPI: 1225207186
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANCHEZ
FirstName: SEAN
MiddleName: I
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3649
Address2:  
City: SPOKANE
State: WA
PostalCode: 992203649
CountryCode: US
TelephoneNumber: 5098382531
FaxNumber: 5097556580
Practice Location
Address1: 605 E HOLLAND AVE
Address2: SUITE 200
City: SPOKANE
State: WA
PostalCode: 992182225
CountryCode: US
TelephoneNumber: 5098382531
FaxNumber: 5097556580
Other Information
ProviderEnumerationDate: 02/25/2008
LastUpdateDate: 04/11/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X059959GAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RN0300X059959GAN Allopathic & Osteopathic PhysiciansInternal MedicineNephrology
207R00000XBC60236553WAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RN0300XBC60236553WAY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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