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General NPI Number Information
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NPI Number | 1417650136
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Entity Type | Individual
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Provider Name | SARAH RUTH BLANCHETTE LICSWA
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Gender | Female
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 905 NE 68TH ST # B4
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City | VANCOUVER
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State | WA
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Zip | 98665-0585
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Country | US
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Telephone | 503-501-6969
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Fax |
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Provider Business Mailing Address
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Address Line | 30012 NE 271ST ST
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City | YACOLT
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State | WA
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Zip | 98675-9584
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Country | US
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Telephone | 503-501-6969
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SC60913007
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License Number State | WA
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