Provider Demographics
NPI:1699050492
Name:SANDEMAN, JOSHUA FITZGERALD (FNP)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:FITZGERALD
Last Name:SANDEMAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 ATWATER ST N OFC
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:OR
Mailing Address - Zip Code:97361-1801
Mailing Address - Country:US
Mailing Address - Phone:503-378-7526
Mailing Address - Fax:503-585-4278
Practice Address - Street 1:180 ATWATER ST N OFC
Practice Address - Street 2:
Practice Address - City:MONMOUTH
Practice Address - State:OR
Practice Address - Zip Code:97361
Practice Address - Country:US
Practice Address - Phone:503-378-7526
Practice Address - Fax:503-585-4278
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21378363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily