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NPI Code Detail

MEDICARE: MS. SADIE JOANN CHATBURN LISW

MEDICARE:  MS. SADIE JOANN CHATBURN  LISW
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
1101Y00000XCounselorSC60779078WA
2101YM0800XMental Health CounselorRC#00049894WA
3104100000XSocial WorkerLW61351551WA

General Provider Information

NPI Number : 1780716399
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SADIE JOANN CHATBURN LISW
Provider Business Mailing Address
First Line : 2020 LAKE HEIGHTS DR APT B202
Second Line :
City : EVERETT
State : WA
Zip : 98208-6037
Country : US
Telephone Number : 425-405-8280
Fax Number :
Provider Business Practice Location Address
First Line : 5802 RAINIER AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98118-2706
Country : US
Telephone Number : 206-323-0930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 01/15/2024

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Directions to “ MS. SADIE JOANN CHATBURN LISW” Practice Location

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