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General NPI Number Information
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NPI Number | 1205606357
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Entity Type | Individual
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Provider Name | REKARLDO RICHARD LE-PAUL SAGE
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Gender | Male
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 851 POPLAR PL S
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City | SEATTLE
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State | WA
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Zip | 98144-2827
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Country | US
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Telephone | 206-507-6559
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Fax | 206-324-4952
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Provider Business Mailing Address
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Address Line | 1425 SPRING ST APT 501
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City | SEATTLE
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State | WA
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Zip | 98104-1632
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Country | US
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Telephone | 407-456-1163
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | WA
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