Basic Information
Provider Information
NPI: 1306152970
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANCHEZ
FirstName: DEBRA
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9330 59TH AVE SW
Address2:  
City: LAKEWOOD
State: WA
PostalCode: 984992858
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 9330 59TH AVE SW
Address2:  
City: LAKEWOOD
State: WA
PostalCode: 984992858
CountryCode: US
TelephoneNumber: 2535817020
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/20/2010
LastUpdateDate: 08/20/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPY60140421WAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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