Provider Demographics
NPI:1497132211
Name:BUCHANAN, SAMANTHA BLAIR
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:BLAIR
Last Name:BUCHANAN
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 1:33600 6TH AVE S STE 240
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6743
Mailing Address - Country:US
Mailing Address - Phone:253-347-1035
Mailing Address - Fax:
Practice Address - Street 1:33600 6TH AVE S STE 240
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6743
Practice Address - Country:US
Practice Address - Phone:253-347-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health