MEDICARE: SARAH LANDRUMTHERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	LH60433967	WA

General Provider Information

NPI Number	:	1053735472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARAH LANDRUMTHERAPY

Provider Business Mailing Address
First Line	:	444 NE RAVENNA BLVD
Second Line	:	309
City	:	SEATTLE
State	:	WA
Zip	:	98115-8436
Country	:	US
Telephone Number	:	206-383-4148
Fax Number	:

Provider Business Practice Location Address
First Line	:	14343 37TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-3734
Country	:	US
Telephone Number	:	206-383-4148
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	SARAH C LANDRUM
Credential	:	M.A.
Telephone Number	:	206-383-4148

Provider Enumeration Date	:	02/05/2014
Last Update Date	:	02/05/2014

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