Provider Demographics
NPI:1467095331
Name:SAGARIS, ANNE WHITE
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:WHITE
Last Name:SAGARIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2902
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-2902
Mailing Address - Country:US
Mailing Address - Phone:360-779-4005
Mailing Address - Fax:360-394-1707
Practice Address - Street 1:19500 10TH AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6553
Practice Address - Country:US
Practice Address - Phone:360-779-4005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health