Provider Demographics
NPI:1265022453
Name:SPRATT, SAMANTHA L (CSWA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:L
Last Name:SPRATT
Suffix:
Gender:F
Credentials:CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NETARTS HWY W
Mailing Address - Street 2:
Mailing Address - City:TILLAMOOK
Mailing Address - State:OR
Mailing Address - Zip Code:97141-9476
Mailing Address - Country:US
Mailing Address - Phone:503-812-7452
Mailing Address - Fax:
Practice Address - Street 1:600 NETARTS HWY W
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141-9476
Practice Address - Country:US
Practice Address - Phone:503-812-7452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA130811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical