Provider Demographics
NPI:1598904229
Name:GROEN-COLYN, SARAH (PHD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GROEN-COLYN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23107 100TH AVE W
Mailing Address - Street 2:SUITE 5
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-5062
Mailing Address - Country:US
Mailing Address - Phone:425-774-8049
Mailing Address - Fax:
Practice Address - Street 1:23107 100TH AVE W
Practice Address - Street 2:SUITE 5
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-5062
Practice Address - Country:US
Practice Address - Phone:425-774-8049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002808103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical