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Individual

SANDRA M AUGUSTINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
5455 ALMIRA DR SE, BREMERTON, WA 98311-8330
(360) 373-5031
Mailing address
5455 ALMIRA DR SE, BREMERTON, WA 98311-8330
(360) 373-5031

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LH00005152
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
228303
MANAGED HEALTH NETWORK
WA
01
91102010657
KITSAP PHYSICIANS SERVICE
WA
01
A039
TRICARE
WA
Enumeration date
01/23/2007
Last updated
07/08/2007
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