Provider Demographics
NPI:1053129213
Name:THLUAI, SANDY K (BS, MBA)
Entity type:Individual
Prefix:MS
First Name:SANDY
Middle Name:K
Last Name:THLUAI
Suffix:
Gender:F
Credentials:BS, MBA
Other - Prefix:
Other - First Name:SAN
Other - Middle Name:KIP
Other - Last Name:THLUAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS, MBA
Mailing Address - Street 1:21313 109TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-2161
Mailing Address - Country:US
Mailing Address - Phone:206-234-4939
Mailing Address - Fax:
Practice Address - Street 1:21313 109TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-2161
Practice Address - Country:US
Practice Address - Phone:206-234-4939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASA1650171R00000X
WA27400850171R00000X
WAMA2705171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter