Basic Information
| Provider Information | |||||||||
| NPI: | 1447687579 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCQUEEN | ||||||||
| FirstName: | SANDI | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 34703 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981241703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067643335 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7803 NE FOURTH PLN RD | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986627246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603979211 | ||||||||
| FaxNumber: | 3602547203 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2013 | ||||||||
| LastUpdateDate: | 10/03/2013 | ||||||||
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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 | 101Y00000X | CG60298100 | WA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.