Healthcare Provider Details

I. General information

NPI: 1588944417
Provider Name (Legal Business Name): SARAH LAUREN ECKSTEIN PH.D., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2011
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NE 136TH AVE STE 200
VANCOUVER WA
98684-6937
US

IV. Provider business mailing address

701 NE 136TH AVE STE 200
VANCOUVER WA
98684-6937
US

V. Phone/Fax

Practice location:
  • Phone: 503-893-9889
  • Fax: 503-386-2645
Mailing address:
  • Phone: 503-893-9889
  • Fax: 503-386-2645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3086
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY61296860
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: