Provider Demographics
NPI:1427178482
Name:STURGIS, SANDRA LEE
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LEE
Last Name:STURGIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SANDI
Other - Middle Name:
Other - Last Name:STURGIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED
Mailing Address - Street 1:7922 150TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8401
Mailing Address - Country:US
Mailing Address - Phone:425-338-5924
Mailing Address - Fax:360-294-5001
Practice Address - Street 1:7922 150TH ST SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-8401
Practice Address - Country:US
Practice Address - Phone:425-338-5924
Practice Address - Fax:360-294-5001
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004647101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health