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NPI Code Detail

MEDICARE: SANDARAH ABRAHAMSON-AMUN MA

MEDICARE: SANDARAH ABRAHAMSON-AMUN MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLH00010909WA

General Provider Information

NPI Number : 1194793059
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDARAH ABRAHAMSON-AMUN MA
Provider Business Mailing Address
First Line : 320 TOWNSHIP ST
Second Line :
City : SEDRO WOOLLEY
State : WA
Zip : 98284-1242
Country : US
Telephone Number : 360-333-0602
Fax Number : 360-873-8041
Provider Business Practice Location Address
First Line : 117 N 1ST ST STE 55
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98273-2858
Country : US
Telephone Number : 360-588-4950
Fax Number : 360-873-8041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 02/21/2020

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