Provider Demographics
NPI:1326377250
Name:SACKMAN, SONJA SELTZER (PHD)
Entity Type:Individual
Prefix:DR
First Name:SONJA
Middle Name:SELTZER
Last Name:SACKMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24122 129TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-7511
Mailing Address - Country:US
Mailing Address - Phone:206-799-9764
Mailing Address - Fax:
Practice Address - Street 1:19001 VASHON HWY SW
Practice Address - Street 2:SUITE 206
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-5214
Practice Address - Country:US
Practice Address - Phone:206-799-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPSYC.PY.60098279103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical