MEDICARE: SARA DALE

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	103TC0700X	Clinical Psychologist	PY00003088	WA

General Provider Information

NPI Number	:	1922490309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA DALE

Provider Business Mailing Address
First Line	:	7330 21ST AVE NW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98117-5623
Country	:	US
Telephone Number	:	206-257-9471
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 1ST AVE N # 311
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-2301
Country	:	US
Telephone Number	:	206-257-9471
Fax Number	:

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

Provider Enumeration Date	:	02/23/2015
Last Update Date	:	12/29/2021

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Directions to “ SARA DALE ” Practice Location

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