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:
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Health care specialties

SpecialtyCodeLicense #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 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356573356 NPPES
Texas Other P008004030 RAILROAD
Texas MEDICAID 2138409 RAILROAD
Texas MEDICAID 208820501 RAILROAD

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