Healthcare Provider Details
I. General information
NPI: 1356586473
Provider Name (Legal Business Name): SANDRA LYNNE REEVES REGISTERED COUNSELOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/03/2008
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10121 EVERGREEN WAY STE 25
EVERETT WA
98204-3880
US
IV. Provider business mailing address
10121 EVERGREEN WAY STE 25 BOX 728
EVERETT WA
98204-3880
US
V. Phone/Fax
- Phone: 425-501-9073
- Fax:
- Phone: 425-501-9073
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | MHC.LH.60164750 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: