Provider Demographics
NPI:1780094375
Name:DOUGLAS-SANDILANDS, BARBARA KATHERINE (LICSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:KATHERINE
Last Name:DOUGLAS-SANDILANDS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:DOUGLAS-SANDILANDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:1912 F STREET
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663
Mailing Address - Country:US
Mailing Address - Phone:360-977-3040
Mailing Address - Fax:
Practice Address - Street 1:1912 F ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3344
Practice Address - Country:US
Practice Address - Phone:360-977-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASWI.LW.602750031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical