Provider Demographics
NPI:1093834475
Name:SANDERS, BARBARA (LMP, LMHC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LMP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 OVERHULSE RD NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4049
Mailing Address - Country:US
Mailing Address - Phone:360-858-1681
Mailing Address - Fax:
Practice Address - Street 1:420 HOWANUT RD
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:WA
Practice Address - Zip Code:68568
Practice Address - Country:US
Practice Address - Phone:360-858-1681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006903101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00006903OtherLICENSE