Provider Demographics
NPI:1366922890
Name:KARDELEN, SARAH ELIZABETH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:KARDELEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4636 E MARGINAL WAY S STE B130
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98134-2374
Mailing Address - Country:US
Mailing Address - Phone:269-275-8368
Mailing Address - Fax:206-588-1090
Practice Address - Street 1:4636 E MARGINAL WAY S STE B130
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-2374
Practice Address - Country:US
Practice Address - Phone:269-275-8368
Practice Address - Fax:206-588-1090
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program