Healthcare Provider Details

I. General information

NPI: 1073795159
Provider Name (Legal Business Name): SARAH A HULL MED, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 11/16/2024
Certification Date: 11/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W ORCHARD AVE
SELAH WA
98942-1329
US

IV. Provider business mailing address

102 N 37TH AVE
YAKIMA WA
98902-2708
US

V. Phone/Fax

Practice location:
  • Phone: 509-208-5672
  • Fax:
Mailing address:
  • Phone: 509-208-5672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLH60680303
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCG60149868
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: