1730357948 NPI number — MS. SARAH B. GORTLER

Table of content: MS. SARAH B. GORTLER (NPI 1730357948)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730357948 NPI number — MS. SARAH B. GORTLER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GORTLER
Provider First Name:
SARAH
Provider Middle Name:
B.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARASH
Provider Other First Name:
SARAH
Provider Other Middle Name:
B,
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730357948
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 16TH AVE
Provider Second Line Business Mailing Address:
JEWISH FAMILY SERVICE
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98122-4011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-461-3240
Provider Business Mailing Address Fax Number:
206-461-3696

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 16TH AVE
Provider Second Line Business Practice Location Address:
JEWISH FAMILY SERVICE
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98122-4011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-461-3240
Provider Business Practice Location Address Fax Number:
206-461-3696
Provider Enumeration Date:
02/11/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LH00005965 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)