Provider Demographics
NPI:1699241869
Name:SANCHEZ, KASAUNDRA (CNA)
Entity type:Individual
Prefix:
First Name:KASAUNDRA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:CNA
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 1952
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-1952
Mailing Address - Country:US
Mailing Address - Phone:253-677-2837
Mailing Address - Fax:
Practice Address - Street 1:29602 64TH AVE S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:WA
Practice Address - Zip Code:98580-8700
Practice Address - Country:US
Practice Address - Phone:253-677-2837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide