Bodack, Sara Michelle
Bodack, Sara Michelle is an individual health care provider with primary practice located at 2525 Ne 139Th St Ste 230 , Vancouver WA 98686-2719. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Bodack, Sara Michelle can be contacted via phone (360) 882-2778.Contact Information
Primary practice address
2525 Ne 139Th St Ste 230
Vancouver WA 98686-2719
Phone: (360) 882-2778
Fax: (360) 604-1673
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | 80250 | Texas |
Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | LD60953985 | Washington |
Profile Details
NPI number | 1356573356 |
---|---|
LBN Legal business name | Bodack, Sara Michelle |
Credentials | AU.D. |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 10th, 2009 |
Last updated | Sep 30th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1356573356 | NPPES |
Texas | Other | P008004030 | RAILROAD |
Texas | MEDICAID | 2138409 | RAILROAD |
Texas | MEDICAID | 208820501 | RAILROAD |
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