Provider Demographics
NPI:1184825093
Name:SLATER, SARA J (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:J
Last Name:SLATER
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12737 BEL RED RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2699
Mailing Address - Country:US
Mailing Address - Phone:206-579-1729
Mailing Address - Fax:425-454-2713
Practice Address - Street 1:12737 BEL RED RD
Practice Address - Street 2:SUITE 230
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2699
Practice Address - Country:US
Practice Address - Phone:206-579-1729
Practice Address - Fax:425-454-2713
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000093011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical