Provider Demographics
NPI:1730357948
Name:GORTLER, SARAH B
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:B
Last Name:GORTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:B,
Other - Last Name:BARASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MC
Mailing Address - Street 1:1601 16TH AVE
Mailing Address - Street 2:JEWISH FAMILY SERVICE
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4011
Mailing Address - Country:US
Mailing Address - Phone:206-461-3240
Mailing Address - Fax:206-461-3696
Practice Address - Street 1:1601 16TH AVE
Practice Address - Street 2:JEWISH FAMILY SERVICE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4011
Practice Address - Country:US
Practice Address - Phone:206-461-3240
Practice Address - Fax:206-461-3696
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health