Provider Demographics
NPI:1275629974
Name:SATHER, KIMBERLY JILL (MA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JILL
Last Name:SATHER
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 1:4807 196TH ST. S.W,
Mailing Address - Street 2:#100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125
Mailing Address - Country:US
Mailing Address - Phone:425-774-4269
Mailing Address - Fax:425-744-1216
Practice Address - Street 1:4807 196TH ST. S.W,
Practice Address - Street 2:#100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:425-774-4269
Practice Address - Fax:425-744-1216
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005288101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health