Provider Demographics
NPI:1982039228
Name:LUNSFORD, SARA ALEJANDRA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ALEJANDRA
Last Name:LUNSFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 375
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-0375
Mailing Address - Country:US
Mailing Address - Phone:360-856-3054
Mailing Address - Fax:360-676-2144
Practice Address - Street 1:614 PETERSON RD STE 200
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-2606
Practice Address - Country:US
Practice Address - Phone:360-856-3054
Practice Address - Fax:360-676-2144
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60408559101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor