Individual
PHANHMALY SAYASANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
9040 JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431-1100
(253) 477-5109
Mailing address
9040 REID ST # A, JOINT BASE LEWIS MCCHORD, WA 98431-1100
(253) 968-2252
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2543
CO
103TC0700X
Clinical Psychologist
Primary
PY60855849
WA
Other
Enumeration date
12/18/2006
Last updated
10/19/2020
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