Provider Demographics
NPI:1023528106
Name:KOMATSU, SARAH CAMILE (MS, MHP, LMHCA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CAMILE
Last Name:KOMATSU
Suffix:
Gender:F
Credentials:MS, MHP, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N HOWARD ST STE W
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0508
Mailing Address - Country:US
Mailing Address - Phone:360-209-8288
Mailing Address - Fax:
Practice Address - Street 1:2427 E RYAN DR
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-9031
Practice Address - Country:US
Practice Address - Phone:360-209-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC6149453101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health