Provider Demographics
NPI:1053735472
Name:SARAH LANDRUMTHERAPY
Entity type:Organization
Organization Name:SARAH LANDRUMTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:LANDRUM
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:206-383-4148
Mailing Address - Street 1:444 NE RAVENNA BLVD
Mailing Address - Street 2:309
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8436
Mailing Address - Country:US
Mailing Address - Phone:206-383-4148
Mailing Address - Fax:
Practice Address - Street 1:14343 37TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-3734
Practice Address - Country:US
Practice Address - Phone:206-383-4148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60433967251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health