Provider Demographics
NPI:1821007063
Name:BRATZ, SANDRA A (MA)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:A
Last Name:BRATZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WINSLOW WAY E
Mailing Address - Street 2:SUITE 212
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2463
Mailing Address - Country:US
Mailing Address - Phone:206-842-0615
Mailing Address - Fax:206-780-8267
Practice Address - Street 1:600 WINSLOW WAY E
Practice Address - Street 2:#212
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2463
Practice Address - Country:US
Practice Address - Phone:206-842-0615
Practice Address - Fax:206-780-8267
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001926106H00000X
CAMFC20854106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist