Provider Demographics
NPI:1558961177
Name:SANCHEZ, PAIGE MALAI-LEILANI
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:MALAI-LEILANI
Last Name:SANCHEZ
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 1:111 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-1108
Mailing Address - Country:US
Mailing Address - Phone:360-240-0022
Mailing Address - Fax:
Practice Address - Street 1:5610 KITSAP WAY STE 320
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-2266
Practice Address - Country:US
Practice Address - Phone:253-792-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWDL47R2D843B106S00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician