Provider Demographics
NPI:1669632568
Name:DAVISON, SARAH (LMFT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DAVISON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1829
Mailing Address - Country:US
Mailing Address - Phone:425-442-2100
Mailing Address - Fax:360-805-0111
Practice Address - Street 1:204 W MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1829
Practice Address - Country:US
Practice Address - Phone:425-442-2100
Practice Address - Fax:360-805-0111
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002623106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALF00002623OtherSTATE LICENSE