Provider Demographics
NPI:1538159587
Name:BREKKE, SANDIA Y (MD)
Entity type:Individual
Prefix:
First Name:SANDIA
Middle Name:Y
Last Name:BREKKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11335 NE 122ND WAY
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-6933
Mailing Address - Country:US
Mailing Address - Phone:206-895-4292
Mailing Address - Fax:
Practice Address - Street 1:828 HEALTHY WAY STE 330
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7959
Practice Address - Country:US
Practice Address - Phone:206-895-4249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27361207V00000X
NECP297207VG0400X
AK221602207VG0400X
WI52076207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ463456Medicaid
WI35380300Medicaid
AZ463456Medicaid
WI059545300Medicare PIN
WI062671018Medicare PIN