Provider Demographics
NPI:1043716319
Name:CONWAY, SARAH KIRBY (CG60128468)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:KIRBY
Last Name:CONWAY
Suffix:
Gender:F
Credentials:CG60128468
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-1931
Mailing Address - Country:US
Mailing Address - Phone:206-724-5590
Mailing Address - Fax:
Practice Address - Street 1:1014 WALLA WALLA AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-1523
Practice Address - Country:US
Practice Address - Phone:206-724-5590
Practice Address - Fax:206-724-5590
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60128468101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor