Healthcare Provider Details

I. General information

NPI: 1104225218
Provider Name (Legal Business Name): SARAH SUMMER MCKIM THOMAS M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 112TH AVE NE STE 260E
BELLEVUE WA
98004-2937
US

IV. Provider business mailing address

1800 112TH AVE NE STE 260E
BELLEVUE WA
98004-2937
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-2906
  • Fax: 509-821-9219
Mailing address:
  • Phone: 206-486-2906
  • Fax: 509-821-9219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLL60487418
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: