Individual
CHERYL SACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(206) 433-2125
Mailing address
1962 SW 172ND ST, BURIEN, WA 98166-3351
(206) 246-7377
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL 00001768
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL 00001768
SPEECH LANGUAGE PATHOLOGIST LICENSE WASHINGTON STATE
WA
Enumeration date
12/04/2012
Last updated
12/04/2012
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