Provider Demographics
NPI:1871590141
Name:SCHORZMAN, SANDRA K (ARNP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:SCHORZMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 475
Mailing Address - Street 2:
Mailing Address - City:PALOUSE
Mailing Address - State:WA
Mailing Address - Zip Code:99161-0475
Mailing Address - Country:US
Mailing Address - Phone:509-878-8000
Mailing Address - Fax:509-878-8008
Practice Address - Street 1:235 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:PALOUSE
Practice Address - State:WA
Practice Address - Zip Code:99161
Practice Address - Country:US
Practice Address - Phone:509-878-8000
Practice Address - Fax:509-878-8008
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9625658Medicaid
S82362Medicare UPIN
WAAB33132Medicare ID - Type Unspecified