Basic Information
Provider Information
NPI: 1386803211
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HANSON
FirstName: SARAH
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: LICENSED PSYCHOLOGIS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5837 221ST PL SE
Address2:  
City: ISSAQUAH
State: WA
PostalCode: 980278917
CountryCode: US
TelephoneNumber: 4253910887
FaxNumber: 4253917014
Practice Location
Address1: 5837 221ST PL SE
Address2:  
City: ISSAQUAH
State: WA
PostalCode: 980278917
CountryCode: US
TelephoneNumber: 4253910887
FaxNumber: 4253917014
Other Information
ProviderEnumerationDate: 06/05/2008
LastUpdateDate: 09/20/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X60748031WAY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


Home