Healthcare Provider Details

I. General information

NPI: 1356841985
Provider Name (Legal Business Name): SABINE JANNOT STOECKER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2018
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 BROADWAY
EVERETT WA
98201-1720
US

IV. Provider business mailing address

8609 EVERGREEN WAY
EVERETT WA
98208-2619
US

V. Phone/Fax

Practice location:
  • Phone: 425-789-2000
  • Fax: 425-789-2096
Mailing address:
  • Phone: 425-789-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW61528923
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC60754328
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: