Provider Demographics
NPI:1891903316
Name:SANABRIA, TAWNY MICHELLE (MA)
Entity Type:Individual
Prefix:
First Name:TAWNY
Middle Name:MICHELLE
Last Name:SANABRIA
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:P.O. BOX 1073
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321
Mailing Address - Country:US
Mailing Address - Phone:253-261-3789
Mailing Address - Fax:
Practice Address - Street 1:712 MAIN STREET
Practice Address - Street 2:SUITE #F
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321
Practice Address - Country:US
Practice Address - Phone:253-261-3789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002543106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist