MEDICARE: KIMBERLY JILL SATHER 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
1	101YM0800X	Mental Health Counselor	LH00005288	WA

General Provider Information

NPI Number	:	1275629974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY JILL SATHER MA

Provider Business Mailing Address
First Line	:	4807 196TH ST. S.W,
Second Line	:	#100
City	:	SEATTLE
State	:	WA
Zip	:	98125
Country	:	US
Telephone Number	:	425-774-4269
Fax Number	:	425-744-1216

Provider Business Practice Location Address
First Line	:	4807 196TH ST. S.W,
Second Line	:	#100
City	:	SEATTLE
State	:	WA
Zip	:	98125
Country	:	US
Telephone Number	:	425-774-4269
Fax Number	:	425-744-1216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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