Provider Demographics
NPI:1114930773
Name:SAUNDERS, JEAN C (MS)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:C
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 GOETHALS DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-942-2340
Practice Address - Street 1:945 GOETHALS DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-942-3627
Practice Address - Fax:509-547-0827
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004126101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00004126OtherMENTAL HEALTH LICENSE