Provider Demographics
NPI:1235467432
Name:SAIS, CONNIE LOUISE (MA)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:LOUISE
Last Name:SAIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 N 182ND ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4402
Mailing Address - Country:US
Mailing Address - Phone:206-405-0194
Mailing Address - Fax:206-542-5235
Practice Address - Street 1:727 N 182ND ST STE 202
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4402
Practice Address - Country:US
Practice Address - Phone:206-405-0194
Practice Address - Fax:206-542-5235
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-27
Last Update Date:2009-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010648101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health