Provider Demographics
NPI:1912043530
Name:BOWERS, SANDRA GALE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:GALE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:HOQUIAM
Mailing Address - State:WA
Mailing Address - Zip Code:98550
Mailing Address - Country:US
Mailing Address - Phone:360-584-6569
Mailing Address - Fax:
Practice Address - Street 1:400 8TH ST
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550-3600
Practice Address - Country:US
Practice Address - Phone:360-637-8049
Practice Address - Fax:360-637-9048
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WATE00003649103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist