Healthcare Provider Details

I. General information

NPI: 1023246436
Provider Name (Legal Business Name): SABRINA JENNIFER ASH COUNSELOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 06/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 HOWANUT RD
OAKVILLE WA
98568
US

IV. Provider business mailing address

420 HOWANUT ROAD
OAKVILLE WA
98568
US

V. Phone/Fax

Practice location:
  • Phone: 360-273-5504
  • Fax: 360-858-7300
Mailing address:
  • Phone: 360-273-5504
  • Fax: 360-858-7300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRC 00050713
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: