Healthcare Provider Details

I. General information

NPI: 1063208577
Provider Name (Legal Business Name): SARAH HARPER SUDPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 NE 129TH ST
VANCOUVER WA
98686-3324
US

IV. Provider business mailing address

16205 NE 29TH AVE
RIDGEFIELD WA
98642-6921
US

V. Phone/Fax

Practice location:
  • Phone: 360-356-1890
  • Fax:
Mailing address:
  • Phone: 971-506-4718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWIA.SC.70149613
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCO61606359
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: