Provider Demographics
NPI:1912980343
Name:STERLING, SUSAN B (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:B
Last Name:STERLING
Suffix:
Gender:F
Credentials:PHD
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 2648
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-0121
Mailing Address - Country:US
Mailing Address - Phone:425-301-3281
Mailing Address - Fax:425-292-0225
Practice Address - Street 1:310 3RD AVE NE
Practice Address - Street 2:#122
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3300
Practice Address - Country:US
Practice Address - Phone:425-369-8224
Practice Address - Fax:425-369-8215
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWAPY2293103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB05722Medicare ID - Type Unspecified
S62528Medicare UPIN