Basic Information
| Provider Information | |||||||||
| NPI: | 1194202622 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANDHAUS | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 102339 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911892339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065286000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1412 SW 43RD ST STE 310 | ||||||||
| Address2: | |||||||||
| City: | RENTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980574803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252351200 | ||||||||
| FaxNumber: | 4259179465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2018 | ||||||||
| LastUpdateDate: | 06/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 34002TLG | CA | N | Eye and Vision Services Providers | Optometrist | 152W00000X | OD61087735 | WA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.