Basic Information
| Provider Information | |||||||||
| NPI: | 1023108404 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SLOAN | ||||||||
| FirstName: | MERRILY | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21746 SWAN RD | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982738455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604248415 | ||||||||
| FaxNumber: | 3604248415 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 S.2ND STREET | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604193500 | ||||||||
| FaxNumber: | 3604193505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | RC00049944 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.