Basic Information
Provider Information
NPI: 1962642819
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OAKS
FirstName: SARAH
MiddleName: DAVIS
NamePrefix:  
NameSuffix:  
Credential: M.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 790
Address2:  
City: STEVENSON
State: WA
PostalCode: 986480790
CountryCode: US
TelephoneNumber: 5094273850
FaxNumber: 5094273859
Practice Location
Address1: 683 SW ROCK CREEK DRIVE
Address2:  
City: STEVENSON
State: WA
PostalCode: 98648
CountryCode: US
TelephoneNumber: 5094273850
FaxNumber: 5094273859
Other Information
ProviderEnumerationDate: 03/04/2009
LastUpdateDate: 03/04/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000XRC 00052210WAY Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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