Provider Demographics
NPI:1356139745
Name:TATE, SARAH MADISON
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MADISON
Last Name:TATE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7639A WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRCHILD AFB
Mailing Address - State:WA
Mailing Address - Zip Code:99011-3022
Mailing Address - Country:US
Mailing Address - Phone:870-668-0229
Mailing Address - Fax:
Practice Address - Street 1:704 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7559
Practice Address - Country:US
Practice Address - Phone:107-520-8676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health