Provider Demographics
NPI:1639512569
Name:SANCHEZ, SELENA MARIE (HS)
Entity Type:Individual
Prefix:
First Name:SELENA
Middle Name:MARIE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:HS
Other - Prefix:
Other - First Name:SELENA
Other - Middle Name:MARIE
Other - Last Name:BUDNIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HS
Mailing Address - Street 1:128 SW 332ND ST
Mailing Address - Street 2:#302
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-6219
Mailing Address - Country:US
Mailing Address - Phone:623-326-0599
Mailing Address - Fax:
Practice Address - Street 1:128 SW 332ND ST
Practice Address - Street 2:#302
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-6219
Practice Address - Country:US
Practice Address - Phone:623-326-0599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health