MEDICARE: SARAH MCGEEHON

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	103K00000X	Behavior Analyst	1-19-40168	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-19-40168	OTHER		BACB

General Provider Information

NPI Number	:	1538791801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MCGEEHON

Provider Business Mailing Address
First Line	:	8400 5TH AVE NE UNIT 8
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-4163
Country	:	US
Telephone Number	:	206-519-2696
Fax Number	:	206-566-6913

Provider Business Practice Location Address
First Line	:	8400 5TH AVE NE UNIT 8
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-4163
Country	:	US
Telephone Number	:	206-519-2696
Fax Number	:	206-566-6913

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

Provider Enumeration Date	:	02/05/2020
Last Update Date	:	10/19/2021

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