Provider Demographics
NPI:1477096881
Name:BENGSCH, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BENGSCH
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 1:143 NW 85TH ST
Mailing Address - Street 2:501
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3060
Mailing Address - Country:US
Mailing Address - Phone:920-602-6762
Mailing Address - Fax:
Practice Address - Street 1:143 NW 85TH ST
Practice Address - Street 2:501
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3060
Practice Address - Country:US
Practice Address - Phone:920-602-6762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist