Provider Demographics
NPI:1518336759
Name:BRUCE, SABLE ELIZABETH (MA)
Entity Type:Individual
Prefix:MS
First Name:SABLE
Middle Name:ELIZABETH
Last Name:BRUCE
Suffix:
Gender:F
Credentials:MA
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Mailing Address - Street 1:18490 SUQUAMISH WAY NE
Mailing Address - Street 2:PO BOX 1228
Mailing Address - City:SUQUAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98392-9532
Mailing Address - Country:US
Mailing Address - Phone:360-394-8558
Mailing Address - Fax:360-598-1724
Practice Address - Street 1:18490 SUQUAMISH WAY NE
Practice Address - Street 2:SUITE 107
Practice Address - City:SUQUAMISH
Practice Address - State:WA
Practice Address - Zip Code:98392-9532
Practice Address - Country:US
Practice Address - Phone:360-598-8558
Practice Address - Fax:360-598-1724
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMC60317214101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health